<article>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#article09_06_04_1358213</id>
	<title>Hospital Turns Away Ambulances When Computers Go Down</title>
	<author>CmdrTaco</author>
	<datestamp>1244125020000</datestamp>
	<htmltext><a href="http://www.dbms2.com/" rel="nofollow">CurtMonash</a> writes <i>"The Indianapolis Star reports that Tuesday Morning, <a href="http://www.indystar.com/apps/pbcs.dll/article?AID=/20090603/LOCAL18/906030346">Methodist Hospital turned away patients in ambulances</a>, for the first time in its 100-plus history. Why? Because the electronic health records (EHR) system had gone down the prior afternoon &mdash; due to a power surge &mdash; and the backlog of paperwork was no longer tolerable.

If you think about that story, it has a couple of <a href="http://www.networkworld.com/community/node/42410">disturbing aspects</a>.  Clearly the investment in or design of high availability, surge protection, etc. were sadly lacking. But even leaving that aside &mdash; why do problems with paperwork make it necessary to turn away patients?

Maybe the latter is OK, since there obviously were other, more smoothly running hospitals to send the patient to.  Still, the whole story should be held up as a cautionary tale for hospitals and IT suppliers everywhere."</i></htmltext>
<tokenext>CurtMonash writes " The Indianapolis Star reports that Tuesday Morning , Methodist Hospital turned away patients in ambulances , for the first time in its 100-plus history .
Why ? Because the electronic health records ( EHR ) system had gone down the prior afternoon    due to a power surge    and the backlog of paperwork was no longer tolerable .
If you think about that story , it has a couple of disturbing aspects .
Clearly the investment in or design of high availability , surge protection , etc .
were sadly lacking .
But even leaving that aside    why do problems with paperwork make it necessary to turn away patients ?
Maybe the latter is OK , since there obviously were other , more smoothly running hospitals to send the patient to .
Still , the whole story should be held up as a cautionary tale for hospitals and IT suppliers everywhere .
"</tokentext>
<sentencetext>CurtMonash writes "The Indianapolis Star reports that Tuesday Morning, Methodist Hospital turned away patients in ambulances, for the first time in its 100-plus history.
Why? Because the electronic health records (EHR) system had gone down the prior afternoon — due to a power surge — and the backlog of paperwork was no longer tolerable.
If you think about that story, it has a couple of disturbing aspects.
Clearly the investment in or design of high availability, surge protection, etc.
were sadly lacking.
But even leaving that aside — why do problems with paperwork make it necessary to turn away patients?
Maybe the latter is OK, since there obviously were other, more smoothly running hospitals to send the patient to.
Still, the whole story should be held up as a cautionary tale for hospitals and IT suppliers everywhere.
"</sentencetext>
</article>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209809</id>
	<title>Re:In need of a form cycle system</title>
	<author>the\_humeister</author>
	<datestamp>1244131020000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>The problem I see with that is how do you search for stuff exactly? Our system does that too for ER notes, but it can be difficult with how poorly people's handwriting can be.</p></htmltext>
<tokenext>The problem I see with that is how do you search for stuff exactly ?
Our system does that too for ER notes , but it can be difficult with how poorly people 's handwriting can be .</tokentext>
<sentencetext>The problem I see with that is how do you search for stuff exactly?
Our system does that too for ER notes, but it can be difficult with how poorly people's handwriting can be.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209367</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209835</id>
	<title>Overflow in hospitals is actually quite common</title>
	<author>Tyrun</author>
	<datestamp>1244131080000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>3</modscore>
	<htmltext>Turning away patients isn't all that surprising. Hospitals do it all the time whenever they reach capacity. It's called overflow and it's quite common. In this instance their capacity was diminished because their system was in the gutter.

Just my $.02</htmltext>
<tokenext>Turning away patients is n't all that surprising .
Hospitals do it all the time whenever they reach capacity .
It 's called overflow and it 's quite common .
In this instance their capacity was diminished because their system was in the gutter .
Just my $ .02</tokentext>
<sentencetext>Turning away patients isn't all that surprising.
Hospitals do it all the time whenever they reach capacity.
It's called overflow and it's quite common.
In this instance their capacity was diminished because their system was in the gutter.
Just my $.02</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209753</id>
	<title>Re:Nurse != Secretary</title>
	<author>unlametheweak</author>
	<datestamp>1244130780000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>4</modscore>
	<htmltext><p><div class="quote"><p>Nurse != Secretary (Score:1)</p></div><p>I think this has more to do with Management not being able to properly bill insurance companies. Because profit is more important than human lives.</p></div>
	</htmltext>
<tokenext>Nurse ! = Secretary ( Score : 1 ) I think this has more to do with Management not being able to properly bill insurance companies .
Because profit is more important than human lives .</tokentext>
<sentencetext>Nurse != Secretary (Score:1)I think this has more to do with Management not being able to properly bill insurance companies.
Because profit is more important than human lives.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209217</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28214211</id>
	<title>It's not just an inconvenience</title>
	<author>cpufrier37075</author>
	<datestamp>1244106060000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>I'm and ER doc. It is increasingly difficult to care for patients when the electronic system is down. Lab, xray and even such basic things as getting vital signs are all tied into the system.</htmltext>
<tokenext>I 'm and ER doc .
It is increasingly difficult to care for patients when the electronic system is down .
Lab , xray and even such basic things as getting vital signs are all tied into the system .</tokentext>
<sentencetext>I'm and ER doc.
It is increasingly difficult to care for patients when the electronic system is down.
Lab, xray and even such basic things as getting vital signs are all tied into the system.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209367</id>
	<title>In need of a form cycle system</title>
	<author>modmans2ndcoming</author>
	<datestamp>1244129280000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>4</modscore>
	<htmltext><p>The hospital I work for is implimenting a form cycle that allows forms to be printed and scaned back to the EMR. Such a system woudl allow my hospital to use the old paper system but maintain the records electronicly if there was ever a temporary interuption of the EMR.</p></htmltext>
<tokenext>The hospital I work for is implimenting a form cycle that allows forms to be printed and scaned back to the EMR .
Such a system woudl allow my hospital to use the old paper system but maintain the records electronicly if there was ever a temporary interuption of the EMR .</tokentext>
<sentencetext>The hospital I work for is implimenting a form cycle that allows forms to be printed and scaned back to the EMR.
Such a system woudl allow my hospital to use the old paper system but maintain the records electronicly if there was ever a temporary interuption of the EMR.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209825</id>
	<title>Re:A one word answer</title>
	<author>L4t3r4lu5</author>
	<datestamp>1244131080000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Check out the lyrics to <a href="http://www.moron.nl/lyrics/amateur-transplants/mr.-burton-lyrics.html" title="moron.nl">this song <b>*NSFW*</b> </a> [moron.nl] for why asking the patient is not a good idea. It's humour, but poignant.</htmltext>
<tokenext>Check out the lyrics to this song * NSFW * [ moron.nl ] for why asking the patient is not a good idea .
It 's humour , but poignant .</tokentext>
<sentencetext>Check out the lyrics to this song *NSFW*  [moron.nl] for why asking the patient is not a good idea.
It's humour, but poignant.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209467</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212107</id>
	<title>Re:Nurse != Secretary</title>
	<author>Ironica</author>
	<datestamp>1244140740000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>4</modscore>
	<htmltext><p><div class="quote"><p>Actually how about eliminating the problem itself ? If the paperwork is overwhelming, with a reasonable minimum workforce present in the hospital, the government (the recipient of said paperwork),</p></div><p>I work for a non-profit healthcare provider, where 94\% of our patients are below 200\% of the Federal Poverty Level.  Most of *our* paperwork does go to the government... the County as part of the Public-Private Partnership fund, the State as part of OAPP, the Feds as part of our FQHC billing, etc.  (Only about 17\% of our patients even have Medicaid or Medicare).  A lot of that paperwork also goes to our private funders; foundations and corporations that donate to specific programs and then expect us to report on our results.</p><p>But for most hospitals and doctor's offices, most of that paperwork is for billing private insurance companies.  A fraction is for billing public insurance for those without private.  Some is sent straight to the patient.  A lot is for accreditation and patient records, too (and The Joint Commission is a private, non-profit entity... they are who is usually accrediting hospitals and ambulatory care).</p><p><div class="quote"><p> needs to accept the fact that there isn't any paperwork, and foot the bill anyway.</p></div><p>As mentioned above, they're not generally footing the bill.</p><p><div class="quote"><p>Obviously this will present docters with patients without medical records. But better to be treated a bit worse than not at all.</p></div><p>It's not "a bit worse."  Incomplete or inaccurate medical records kill thousands of people every year, and many more suffer permanent or temporary injury as a result.  Giving me or my son certain common antibiotics via IV can kill me.  Medical records are EXTREMELY important, because people are very different from each other.</p><p><div class="quote"><p>Obviously any sort of national healthcare system will preclude having this common-sense approach, as any system that does not make it the responsibility of the patient to ensure medical bills are paid will ration health care ("total health care resources" are limited. Either you let people pay for them, or you ration them). Rationed health care means "no government approval, no healthcare" both in theory and in practice.</p></div><p>I really don't know where this keeps coming from.  Obviously, just like every private insurance company in creation, a government-run health plan would also decide what was worth the money and what wasn't.  This does not currently and could not in the future prevent people from paying out of pocket if they think it's worth it.  I'm not sure how people get from "government provides health care" to "government prohibits the purchase of health care by private entities."</p><p>It is very true that, when confronted with the incredible costs of certain treatments and medications that are declined for coverage, people find themselves unable or unwilling to pay.  It's therefore unlikely that people will just pay out-of-pocket for those services which are not covered.  This does not mean they are prevented from doing so by legislation; it simply means that the person footing the bill is likely to weigh the situation differently.</p><p>[wtf is up with<nobr> <wbr></nobr>/. formatting today?  I've tried everything to put line breaks in the right places, but it keeps running paragraphs together anyway.  Bah.]</p></div>
	</htmltext>
<tokenext>Actually how about eliminating the problem itself ?
If the paperwork is overwhelming , with a reasonable minimum workforce present in the hospital , the government ( the recipient of said paperwork ) ,I work for a non-profit healthcare provider , where 94 \ % of our patients are below 200 \ % of the Federal Poverty Level .
Most of * our * paperwork does go to the government... the County as part of the Public-Private Partnership fund , the State as part of OAPP , the Feds as part of our FQHC billing , etc .
( Only about 17 \ % of our patients even have Medicaid or Medicare ) .
A lot of that paperwork also goes to our private funders ; foundations and corporations that donate to specific programs and then expect us to report on our results.But for most hospitals and doctor 's offices , most of that paperwork is for billing private insurance companies .
A fraction is for billing public insurance for those without private .
Some is sent straight to the patient .
A lot is for accreditation and patient records , too ( and The Joint Commission is a private , non-profit entity... they are who is usually accrediting hospitals and ambulatory care ) .
needs to accept the fact that there is n't any paperwork , and foot the bill anyway.As mentioned above , they 're not generally footing the bill.Obviously this will present docters with patients without medical records .
But better to be treated a bit worse than not at all.It 's not " a bit worse .
" Incomplete or inaccurate medical records kill thousands of people every year , and many more suffer permanent or temporary injury as a result .
Giving me or my son certain common antibiotics via IV can kill me .
Medical records are EXTREMELY important , because people are very different from each other.Obviously any sort of national healthcare system will preclude having this common-sense approach , as any system that does not make it the responsibility of the patient to ensure medical bills are paid will ration health care ( " total health care resources " are limited .
Either you let people pay for them , or you ration them ) .
Rationed health care means " no government approval , no healthcare " both in theory and in practice.I really do n't know where this keeps coming from .
Obviously , just like every private insurance company in creation , a government-run health plan would also decide what was worth the money and what was n't .
This does not currently and could not in the future prevent people from paying out of pocket if they think it 's worth it .
I 'm not sure how people get from " government provides health care " to " government prohibits the purchase of health care by private entities .
" It is very true that , when confronted with the incredible costs of certain treatments and medications that are declined for coverage , people find themselves unable or unwilling to pay .
It 's therefore unlikely that people will just pay out-of-pocket for those services which are not covered .
This does not mean they are prevented from doing so by legislation ; it simply means that the person footing the bill is likely to weigh the situation differently .
[ wtf is up with / .
formatting today ?
I 've tried everything to put line breaks in the right places , but it keeps running paragraphs together anyway .
Bah. ]</tokentext>
<sentencetext>Actually how about eliminating the problem itself ?
If the paperwork is overwhelming, with a reasonable minimum workforce present in the hospital, the government (the recipient of said paperwork),I work for a non-profit healthcare provider, where 94\% of our patients are below 200\% of the Federal Poverty Level.
Most of *our* paperwork does go to the government... the County as part of the Public-Private Partnership fund, the State as part of OAPP, the Feds as part of our FQHC billing, etc.
(Only about 17\% of our patients even have Medicaid or Medicare).
A lot of that paperwork also goes to our private funders; foundations and corporations that donate to specific programs and then expect us to report on our results.But for most hospitals and doctor's offices, most of that paperwork is for billing private insurance companies.
A fraction is for billing public insurance for those without private.
Some is sent straight to the patient.
A lot is for accreditation and patient records, too (and The Joint Commission is a private, non-profit entity... they are who is usually accrediting hospitals and ambulatory care).
needs to accept the fact that there isn't any paperwork, and foot the bill anyway.As mentioned above, they're not generally footing the bill.Obviously this will present docters with patients without medical records.
But better to be treated a bit worse than not at all.It's not "a bit worse.
"  Incomplete or inaccurate medical records kill thousands of people every year, and many more suffer permanent or temporary injury as a result.
Giving me or my son certain common antibiotics via IV can kill me.
Medical records are EXTREMELY important, because people are very different from each other.Obviously any sort of national healthcare system will preclude having this common-sense approach, as any system that does not make it the responsibility of the patient to ensure medical bills are paid will ration health care ("total health care resources" are limited.
Either you let people pay for them, or you ration them).
Rationed health care means "no government approval, no healthcare" both in theory and in practice.I really don't know where this keeps coming from.
Obviously, just like every private insurance company in creation, a government-run health plan would also decide what was worth the money and what wasn't.
This does not currently and could not in the future prevent people from paying out of pocket if they think it's worth it.
I'm not sure how people get from "government provides health care" to "government prohibits the purchase of health care by private entities.
"It is very true that, when confronted with the incredible costs of certain treatments and medications that are declined for coverage, people find themselves unable or unwilling to pay.
It's therefore unlikely that people will just pay out-of-pocket for those services which are not covered.
This does not mean they are prevented from doing so by legislation; it simply means that the person footing the bill is likely to weigh the situation differently.
[wtf is up with /.
formatting today?
I've tried everything to put line breaks in the right places, but it keeps running paragraphs together anyway.
Bah.]
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209725</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28223457</id>
	<title>Diversion != Closed</title>
	<author>ff1324</author>
	<datestamp>1244220720000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Hospitals around here go on diversion on a pretty regular basis. We have a system set up to minimize patient risk.

Diversion means that the facility is not able to provide timely care to a patient whose condition is not critical, and that patient will receive better, more rapid care at another hospital. Why take an MI to a hospital that is experiencing an IT issue causing orders to be delayed, blood labs to be held up, x-rays to not be delivered in a timely fashion, etc...when we can drive 5 minutes further and the patient will be in the cath lab within 30 minutes? We can still take patients to a hospital on diversion if we don't think they'll make it to the next one OR if that hospital has specialty care that is required (such as a burn unit or hyperbaric  chamber).<br> <br>
A hospital being CLOSED is a whole different animal. Here, hospitals have a closed status because they are unable to accept any patients whatsoever. Most recently, we had a hospital closed for 28 hours because a bunch of haz-mat victims left the scene of a hazmat incident and walked into the ED covered in a toxic inhalation chemical.</htmltext>
<tokenext>Hospitals around here go on diversion on a pretty regular basis .
We have a system set up to minimize patient risk .
Diversion means that the facility is not able to provide timely care to a patient whose condition is not critical , and that patient will receive better , more rapid care at another hospital .
Why take an MI to a hospital that is experiencing an IT issue causing orders to be delayed , blood labs to be held up , x-rays to not be delivered in a timely fashion , etc...when we can drive 5 minutes further and the patient will be in the cath lab within 30 minutes ?
We can still take patients to a hospital on diversion if we do n't think they 'll make it to the next one OR if that hospital has specialty care that is required ( such as a burn unit or hyperbaric chamber ) .
A hospital being CLOSED is a whole different animal .
Here , hospitals have a closed status because they are unable to accept any patients whatsoever .
Most recently , we had a hospital closed for 28 hours because a bunch of haz-mat victims left the scene of a hazmat incident and walked into the ED covered in a toxic inhalation chemical .</tokentext>
<sentencetext>Hospitals around here go on diversion on a pretty regular basis.
We have a system set up to minimize patient risk.
Diversion means that the facility is not able to provide timely care to a patient whose condition is not critical, and that patient will receive better, more rapid care at another hospital.
Why take an MI to a hospital that is experiencing an IT issue causing orders to be delayed, blood labs to be held up, x-rays to not be delivered in a timely fashion, etc...when we can drive 5 minutes further and the patient will be in the cath lab within 30 minutes?
We can still take patients to a hospital on diversion if we don't think they'll make it to the next one OR if that hospital has specialty care that is required (such as a burn unit or hyperbaric  chamber).
A hospital being CLOSED is a whole different animal.
Here, hospitals have a closed status because they are unable to accept any patients whatsoever.
Most recently, we had a hospital closed for 28 hours because a bunch of haz-mat victims left the scene of a hazmat incident and walked into the ED covered in a toxic inhalation chemical.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209801</id>
	<title>Nooooo!</title>
	<author>jbacon</author>
	<datestamp>1244131020000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>The title!  They fixed it!  Bastards!</htmltext>
<tokenext>The title !
They fixed it !
Bastards !</tokentext>
<sentencetext>The title!
They fixed it!
Bastards!</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</id>
	<title>A one word answer</title>
	<author>Anonymous</author>
	<datestamp>1244128920000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>5</modscore>
	<htmltext><p>"But even leaving that aside - why do problems with paperwork make it necessary to turn away patients?"</p><p>Lawyers.</p></htmltext>
<tokenext>" But even leaving that aside - why do problems with paperwork make it necessary to turn away patients ?
" Lawyers .</tokentext>
<sentencetext>"But even leaving that aside - why do problems with paperwork make it necessary to turn away patients?
"Lawyers.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210211</id>
	<title>Let's get real here</title>
	<author>rcamans</author>
	<datestamp>1244132760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>If just one of those ambulances turned away had a patient die, the law suits could easily exceed the cost of patient care for all ambulance runs. And for patients taken in, they could have kept them around long enough to get all necessary info. They could have called in temps to help keep up, and catch up.<br>Of course, if the patients had gotten in, it sounds like the hospital would have left them laying around while they did the paperwork.<br>They are just insensitive jerks.</p></htmltext>
<tokenext>If just one of those ambulances turned away had a patient die , the law suits could easily exceed the cost of patient care for all ambulance runs .
And for patients taken in , they could have kept them around long enough to get all necessary info .
They could have called in temps to help keep up , and catch up.Of course , if the patients had gotten in , it sounds like the hospital would have left them laying around while they did the paperwork.They are just insensitive jerks .</tokentext>
<sentencetext>If just one of those ambulances turned away had a patient die, the law suits could easily exceed the cost of patient care for all ambulance runs.
And for patients taken in, they could have kept them around long enough to get all necessary info.
They could have called in temps to help keep up, and catch up.Of course, if the patients had gotten in, it sounds like the hospital would have left them laying around while they did the paperwork.They are just insensitive jerks.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28215637</id>
	<title>Re:A one word answer</title>
	<author>againjj</author>
	<datestamp>1244113200000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>"But even leaving that aside - why do problems with paperwork make it necessary to turn away patients?"</p><p>Lawyers.</p></div><p>
Actually, it sounds like they were not turning away people (not patients, they are not patients until they have entered care), but simply diverting them if they were in an ambulance.  A walk-in can not be sent to another hospital in any reasonable time, which is why they were NOT turned away, but an ambulance can easily choose between hospitals.  Ambulance diversions happen frequently, say to even patient loads or wait times, and it sounds like this was simple another diversion, albeit for an unusual reason.  So, the lawyers had nothing to do with it.</p></div>
	</htmltext>
<tokenext>" But even leaving that aside - why do problems with paperwork make it necessary to turn away patients ? " Lawyers .
Actually , it sounds like they were not turning away people ( not patients , they are not patients until they have entered care ) , but simply diverting them if they were in an ambulance .
A walk-in can not be sent to another hospital in any reasonable time , which is why they were NOT turned away , but an ambulance can easily choose between hospitals .
Ambulance diversions happen frequently , say to even patient loads or wait times , and it sounds like this was simple another diversion , albeit for an unusual reason .
So , the lawyers had nothing to do with it .</tokentext>
<sentencetext>"But even leaving that aside - why do problems with paperwork make it necessary to turn away patients?"Lawyers.
Actually, it sounds like they were not turning away people (not patients, they are not patients until they have entered care), but simply diverting them if they were in an ambulance.
A walk-in can not be sent to another hospital in any reasonable time, which is why they were NOT turned away, but an ambulance can easily choose between hospitals.
Ambulance diversions happen frequently, say to even patient loads or wait times, and it sounds like this was simple another diversion, albeit for an unusual reason.
So, the lawyers had nothing to do with it.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212705</id>
	<title>Republican ammunition</title>
	<author>Anonymous</author>
	<datestamp>1244143260000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>this is just one small example, put out there by Republicans to help fight the Dem's health system plans.</p><p>its dispicable</p></htmltext>
<tokenext>this is just one small example , put out there by Republicans to help fight the Dem 's health system plans.its dispicable</tokentext>
<sentencetext>this is just one small example, put out there by Republicans to help fight the Dem's health system plans.its dispicable</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211351</id>
	<title>paperless office</title>
	<author>hideouspenguinboy</author>
	<datestamp>1244137440000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>enron, lehman brothers, etc.</htmltext>
<tokenext>enron , lehman brothers , etc .</tokentext>
<sentencetext>enron, lehman brothers, etc.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211365</id>
	<title>Re:A one word answer</title>
	<author>dvazquez</author>
	<datestamp>1244137440000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Cause the can't bill them properly afterward.</htmltext>
<tokenext>Cause the ca n't bill them properly afterward .</tokentext>
<sentencetext>Cause the can't bill them properly afterward.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28216679</id>
	<title>Re:A one word answer</title>
	<author>Lunzo</author>
	<datestamp>1244119140000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>A few of the other replies to this comment don't get why its so ridiculous. They assume that patients are lying all the time and the medical records are infallible truth. The thing is much of a patient's medical record will be what they said to doctors in the past, or the doctor's treatment based on what the patient said. If all patients lie then the medical records could be wrong too.</htmltext>
<tokenext>A few of the other replies to this comment do n't get why its so ridiculous .
They assume that patients are lying all the time and the medical records are infallible truth .
The thing is much of a patient 's medical record will be what they said to doctors in the past , or the doctor 's treatment based on what the patient said .
If all patients lie then the medical records could be wrong too .</tokentext>
<sentencetext>A few of the other replies to this comment don't get why its so ridiculous.
They assume that patients are lying all the time and the medical records are infallible truth.
The thing is much of a patient's medical record will be what they said to doctors in the past, or the doctor's treatment based on what the patient said.
If all patients lie then the medical records could be wrong too.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209467</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209217</id>
	<title>Nurse != Secretary</title>
	<author>Anonymous</author>
	<datestamp>1244128800000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext>... in theory, at least.</htmltext>
<tokenext>... in theory , at least .</tokentext>
<sentencetext>... in theory, at least.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209463</id>
	<title>Failure of Engineering</title>
	<author>Anonymous</author>
	<datestamp>1244129640000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>This is just another failure of "Engineering".</p><p>This is what you get when you get "Engineers" to design things, that should have been designed by real-engineers, who can be held accountable.</p><p>The average IT worker is by nowhere near qualified to design systems like this.</p></htmltext>
<tokenext>This is just another failure of " Engineering " .This is what you get when you get " Engineers " to design things , that should have been designed by real-engineers , who can be held accountable.The average IT worker is by nowhere near qualified to design systems like this .</tokentext>
<sentencetext>This is just another failure of "Engineering".This is what you get when you get "Engineers" to design things, that should have been designed by real-engineers, who can be held accountable.The average IT worker is by nowhere near qualified to design systems like this.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211281</id>
	<title>100-plus WHAT history?</title>
	<author>furby076</author>
	<datestamp>1244137200000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>for the first time in its 100-plus history</p></div><p>100 years, months, days, hours, patients, ambulance drop-offs...some details would be nice.</p></div>
	</htmltext>
<tokenext>for the first time in its 100-plus history100 years , months , days , hours , patients , ambulance drop-offs...some details would be nice .</tokentext>
<sentencetext>for the first time in its 100-plus history100 years, months, days, hours, patients, ambulance drop-offs...some details would be nice.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210531</id>
	<title>Patient Participation..</title>
	<author>lionchild</author>
	<datestamp>1244134140000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>3</modscore>
	<htmltext><p>This is the biggest reason I can point out for a patient to be an ACTIVE participant in knowing what their treatment is in a hospital or other medical facility with electronic record systems.  You need to know what you're supposed to be getting and when. If you don't, you should be asking questions until you get satisfactory answers.</p></htmltext>
<tokenext>This is the biggest reason I can point out for a patient to be an ACTIVE participant in knowing what their treatment is in a hospital or other medical facility with electronic record systems .
You need to know what you 're supposed to be getting and when .
If you do n't , you should be asking questions until you get satisfactory answers .</tokentext>
<sentencetext>This is the biggest reason I can point out for a patient to be an ACTIVE participant in knowing what their treatment is in a hospital or other medical facility with electronic record systems.
You need to know what you're supposed to be getting and when.
If you don't, you should be asking questions until you get satisfactory answers.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209945</id>
	<title>The problem with no paperwork</title>
	<author>hessian</author>
	<datestamp>1244131620000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>The problem is mostly legal: if nothing is documented, the other guy's story wins, and one large lawsuit could take down the hospital. If you cannot organize your records, you're going to lose one, and if you lose one for the guy who claims he slipped, broke his back, and now can't work for life, your hospital goes bye-bye.</p><p>Our society has adapted to computers. We require them to move things along at the usual speed. Going back to paper isn't an option. Remote backup and redundant power supplies are a good idea, as that hospital found, but they did the right thing in shutting down instead of taking a huge legal risk.</p></htmltext>
<tokenext>The problem is mostly legal : if nothing is documented , the other guy 's story wins , and one large lawsuit could take down the hospital .
If you can not organize your records , you 're going to lose one , and if you lose one for the guy who claims he slipped , broke his back , and now ca n't work for life , your hospital goes bye-bye.Our society has adapted to computers .
We require them to move things along at the usual speed .
Going back to paper is n't an option .
Remote backup and redundant power supplies are a good idea , as that hospital found , but they did the right thing in shutting down instead of taking a huge legal risk .</tokentext>
<sentencetext>The problem is mostly legal: if nothing is documented, the other guy's story wins, and one large lawsuit could take down the hospital.
If you cannot organize your records, you're going to lose one, and if you lose one for the guy who claims he slipped, broke his back, and now can't work for life, your hospital goes bye-bye.Our society has adapted to computers.
We require them to move things along at the usual speed.
Going back to paper isn't an option.
Remote backup and redundant power supplies are a good idea, as that hospital found, but they did the right thing in shutting down instead of taking a huge legal risk.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28217715</id>
	<title>Rhetoricals</title>
	<author>Narcogen</author>
	<datestamp>1244128500000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>"why do problems with paperwork make it necessary to turn away patients?"</p><p>Before posting a rhetorical question try answering it yourself. It may not hold up.</p><p>What do you think would happen the first time a patient died or suffered other permanent consequences as a result of improper treatment due to missing or incorrect paperwork describing their condition and medical history? Those ambulances didn't drive into the river. They went to another hospital, one with a working computer that could give doctors in the emergency room the information they need to have the best chance of delivering the proper treatment.</p></htmltext>
<tokenext>" why do problems with paperwork make it necessary to turn away patients ?
" Before posting a rhetorical question try answering it yourself .
It may not hold up.What do you think would happen the first time a patient died or suffered other permanent consequences as a result of improper treatment due to missing or incorrect paperwork describing their condition and medical history ?
Those ambulances did n't drive into the river .
They went to another hospital , one with a working computer that could give doctors in the emergency room the information they need to have the best chance of delivering the proper treatment .</tokentext>
<sentencetext>"why do problems with paperwork make it necessary to turn away patients?
"Before posting a rhetorical question try answering it yourself.
It may not hold up.What do you think would happen the first time a patient died or suffered other permanent consequences as a result of improper treatment due to missing or incorrect paperwork describing their condition and medical history?
Those ambulances didn't drive into the river.
They went to another hospital, one with a working computer that could give doctors in the emergency room the information they need to have the best chance of delivering the proper treatment.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28214573</id>
	<title>Re:Nurse != Secretary</title>
	<author>Dravik</author>
	<datestamp>1244108040000</datestamp>
	<modclass>None</modclass>
	<modscore>2</modscore>
	<htmltext>
<p>I'm not sure how people get from "government provides health care" to "government prohibits the purchase of health care by private entities."</p><p>People get there because of restrictions in Canada and England that do effectively prohibit purchase of health care by private entities.</p></htmltext>
<tokenext>I 'm not sure how people get from " government provides health care " to " government prohibits the purchase of health care by private entities .
" People get there because of restrictions in Canada and England that do effectively prohibit purchase of health care by private entities .</tokentext>
<sentencetext>
I'm not sure how people get from "government provides health care" to "government prohibits the purchase of health care by private entities.
"People get there because of restrictions in Canada and England that do effectively prohibit purchase of health care by private entities.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212107</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211425</id>
	<title>Re:A one word answer</title>
	<author>kenp2002</author>
	<datestamp>1244137680000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>... "But even leaving that aside - why do problems with paperwork make it necessary to turn away patients?"</p><p>Lawyers...</p><p>No, you one word answer is "Plaintiffs."</p><p>Lawyers normally cannot bring a suit themselves on their own, they have to have a client they work for. That person, paying the lawyer, is the douche. Next thing you'll tell me is the gun killed the victim rather then the guy firing the gun. Lawyers=Guns in this analogy.<nobr> <wbr></nobr>.. ahem the wife would also like to point out that the paralegal working for the Lawyer is the bullet. The gun gets the glory, but the bullet is up until 4 am pulling the data the lawyer needs...</p></htmltext>
<tokenext>... " But even leaving that aside - why do problems with paperwork make it necessary to turn away patients ?
" Lawyers...No , you one word answer is " Plaintiffs .
" Lawyers normally can not bring a suit themselves on their own , they have to have a client they work for .
That person , paying the lawyer , is the douche .
Next thing you 'll tell me is the gun killed the victim rather then the guy firing the gun .
Lawyers = Guns in this analogy .
.. ahem the wife would also like to point out that the paralegal working for the Lawyer is the bullet .
The gun gets the glory , but the bullet is up until 4 am pulling the data the lawyer needs.. .</tokentext>
<sentencetext>... "But even leaving that aside - why do problems with paperwork make it necessary to turn away patients?
"Lawyers...No, you one word answer is "Plaintiffs.
"Lawyers normally cannot bring a suit themselves on their own, they have to have a client they work for.
That person, paying the lawyer, is the douche.
Next thing you'll tell me is the gun killed the victim rather then the guy firing the gun.
Lawyers=Guns in this analogy.
.. ahem the wife would also like to point out that the paralegal working for the Lawyer is the bullet.
The gun gets the glory, but the bullet is up until 4 am pulling the data the lawyer needs...</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210753</id>
	<title>Re:Nurse != Secretary</title>
	<author>penguin\_dance</author>
	<datestamp>1244135040000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>It's NOT just billing...many medical places are getting rid of their hard copy paper records and relying on electronic ones. My allergist did this (staff was not real happy about having to rely on laptops.) So that puppy holds all your medical records and a hospital doing same would not be able to transfer over any records such as what drugs you're allergic to or what the previous attanding physician prescribed.</p><p>I think it really shows just how much MORE paperwork they have to deal with. As the computers have decreased in size and cost and increased in capability, the paperwork involved has increased. No one would have be able to handle this much paperwork having to rely on handwritten or even typed records. (In theory we should be decreasing workload, but instead they think of more things they can do or require and so the workload increases.)</p><p>Secretaries are either evolving or dying off because once future managers began learning computer skills, they no longer needed to have someone else type up their dictation or letters. And of course it saved company $$. Only the most senior staff get a personal secretary because they have the status and I suspect most are the leftover codgers who never learned to type.</p></htmltext>
<tokenext>It 's NOT just billing...many medical places are getting rid of their hard copy paper records and relying on electronic ones .
My allergist did this ( staff was not real happy about having to rely on laptops .
) So that puppy holds all your medical records and a hospital doing same would not be able to transfer over any records such as what drugs you 're allergic to or what the previous attanding physician prescribed.I think it really shows just how much MORE paperwork they have to deal with .
As the computers have decreased in size and cost and increased in capability , the paperwork involved has increased .
No one would have be able to handle this much paperwork having to rely on handwritten or even typed records .
( In theory we should be decreasing workload , but instead they think of more things they can do or require and so the workload increases .
) Secretaries are either evolving or dying off because once future managers began learning computer skills , they no longer needed to have someone else type up their dictation or letters .
And of course it saved company $ $ .
Only the most senior staff get a personal secretary because they have the status and I suspect most are the leftover codgers who never learned to type .</tokentext>
<sentencetext>It's NOT just billing...many medical places are getting rid of their hard copy paper records and relying on electronic ones.
My allergist did this (staff was not real happy about having to rely on laptops.
) So that puppy holds all your medical records and a hospital doing same would not be able to transfer over any records such as what drugs you're allergic to or what the previous attanding physician prescribed.I think it really shows just how much MORE paperwork they have to deal with.
As the computers have decreased in size and cost and increased in capability, the paperwork involved has increased.
No one would have be able to handle this much paperwork having to rely on handwritten or even typed records.
(In theory we should be decreasing workload, but instead they think of more things they can do or require and so the workload increases.
)Secretaries are either evolving or dying off because once future managers began learning computer skills, they no longer needed to have someone else type up their dictation or letters.
And of course it saved company $$.
Only the most senior staff get a personal secretary because they have the status and I suspect most are the leftover codgers who never learned to type.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209753</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211651</id>
	<title>Incompetence</title>
	<author>The Cisco Kid</author>
	<datestamp>1244138580000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Anyone designing systems for hospitals, the failure of which would interfere with the hospital's ability to provide care, especially emergency care, to patients (whether the failure of a records and billing system \_should\_ interfere is a separate debate, but if the hospital considers it so, then it counts here) that doesn't ensure that something as simple as a *power surge* can't cause it to fail, is utterly incompetent to be remotely involved in the designing of systems for hospitals.</p><p>That would include building anything on any Microsoft platform, as well as not having 100\% fault tolerant isolated power systems.</p></htmltext>
<tokenext>Anyone designing systems for hospitals , the failure of which would interfere with the hospital 's ability to provide care , especially emergency care , to patients ( whether the failure of a records and billing system \ _should \ _ interfere is a separate debate , but if the hospital considers it so , then it counts here ) that does n't ensure that something as simple as a * power surge * ca n't cause it to fail , is utterly incompetent to be remotely involved in the designing of systems for hospitals.That would include building anything on any Microsoft platform , as well as not having 100 \ % fault tolerant isolated power systems .</tokentext>
<sentencetext>Anyone designing systems for hospitals, the failure of which would interfere with the hospital's ability to provide care, especially emergency care, to patients (whether the failure of a records and billing system \_should\_ interfere is a separate debate, but if the hospital considers it so, then it counts here) that doesn't ensure that something as simple as a *power surge* can't cause it to fail, is utterly incompetent to be remotely involved in the designing of systems for hospitals.That would include building anything on any Microsoft platform, as well as not having 100\% fault tolerant isolated power systems.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28214709</id>
	<title>Re:Nurse != Secretary</title>
	<author>caluml</author>
	<datestamp>1244108760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>Ya, until you go back to the hosipital and the next doctor on staff doesn't know the dosage of medication you were put on, and gives you something that shouldn't be combined with the previous medication.</p></div><p>Are you incapable of telling him yourself? Are you taking stuff, without knowing what and how much?</p></div>
	</htmltext>
<tokenext>Ya , until you go back to the hosipital and the next doctor on staff does n't know the dosage of medication you were put on , and gives you something that should n't be combined with the previous medication.Are you incapable of telling him yourself ?
Are you taking stuff , without knowing what and how much ?</tokentext>
<sentencetext>Ya, until you go back to the hosipital and the next doctor on staff doesn't know the dosage of medication you were put on, and gives you something that shouldn't be combined with the previous medication.Are you incapable of telling him yourself?
Are you taking stuff, without knowing what and how much?
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210253</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209749</id>
	<title>IT Kills When In Hospitals</title>
	<author>Anonymous</author>
	<datestamp>1244130720000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>2</modscore>
	<htmltext><p>Years ago, probably in the early 1980's, a friend of the family had to be checked into a hospital.  She was on dialisys (kidney disease) and obese and had other troubles associated with the combination of those two conditions.  Things went wrong for her pretty frequently.</p><p>The hospital food cart kept bringer her food that would flat out kill her: no kidneys means no ability to deal with floods of certain chemicals -- potassium, for example.  She used to joke about committing "bananacide".  She could just eat a few bananas and sit down to wait for the inevitable.</p><p>Day after day, meal after meal, the food cart would bring her food she couldn't eat.  She was going hungry when she was sick.  She would plead with the staff, but they didn't change anything.</p><p>My father went to visit her and she begged him to help her.  She was getting weaker every day.  He talked to the staff and pursued the problem until he got to one of the people actually choosing the meals.</p><p>The nutritionists were doing the right thing.  They were picking the right foods for someone who was obese and had other problems.  They were NOT considering the fact that her kidneys didn't work.  Why?  Because the screen they saw only had room for a few conditions.  The last one on the list -- Kidney failure -- wasn't showing.  There were a fixed number of lines.</p><p>Someone had to shuffle the order of the values so that the various nutritionists, with their hundreds of patients a day, could keep track of what to feed her from then on.</p><p>She died a few days later.</p><p>Was it because she'd been underfed for days?  Would feeding her have helped?  I don't know.</p><p>But the story illustrates how a reasonable assumption made by someone in the chain that you'd need, let's say "four" lines in that field there, could kill someone.</p><p>Surge suppression seems like a no brainer, but the people making the decisions are not always the people who should be.</p></htmltext>
<tokenext>Years ago , probably in the early 1980 's , a friend of the family had to be checked into a hospital .
She was on dialisys ( kidney disease ) and obese and had other troubles associated with the combination of those two conditions .
Things went wrong for her pretty frequently.The hospital food cart kept bringer her food that would flat out kill her : no kidneys means no ability to deal with floods of certain chemicals -- potassium , for example .
She used to joke about committing " bananacide " .
She could just eat a few bananas and sit down to wait for the inevitable.Day after day , meal after meal , the food cart would bring her food she could n't eat .
She was going hungry when she was sick .
She would plead with the staff , but they did n't change anything.My father went to visit her and she begged him to help her .
She was getting weaker every day .
He talked to the staff and pursued the problem until he got to one of the people actually choosing the meals.The nutritionists were doing the right thing .
They were picking the right foods for someone who was obese and had other problems .
They were NOT considering the fact that her kidneys did n't work .
Why ? Because the screen they saw only had room for a few conditions .
The last one on the list -- Kidney failure -- was n't showing .
There were a fixed number of lines.Someone had to shuffle the order of the values so that the various nutritionists , with their hundreds of patients a day , could keep track of what to feed her from then on.She died a few days later.Was it because she 'd been underfed for days ?
Would feeding her have helped ?
I do n't know.But the story illustrates how a reasonable assumption made by someone in the chain that you 'd need , let 's say " four " lines in that field there , could kill someone.Surge suppression seems like a no brainer , but the people making the decisions are not always the people who should be .</tokentext>
<sentencetext>Years ago, probably in the early 1980's, a friend of the family had to be checked into a hospital.
She was on dialisys (kidney disease) and obese and had other troubles associated with the combination of those two conditions.
Things went wrong for her pretty frequently.The hospital food cart kept bringer her food that would flat out kill her: no kidneys means no ability to deal with floods of certain chemicals -- potassium, for example.
She used to joke about committing "bananacide".
She could just eat a few bananas and sit down to wait for the inevitable.Day after day, meal after meal, the food cart would bring her food she couldn't eat.
She was going hungry when she was sick.
She would plead with the staff, but they didn't change anything.My father went to visit her and she begged him to help her.
She was getting weaker every day.
He talked to the staff and pursued the problem until he got to one of the people actually choosing the meals.The nutritionists were doing the right thing.
They were picking the right foods for someone who was obese and had other problems.
They were NOT considering the fact that her kidneys didn't work.
Why?  Because the screen they saw only had room for a few conditions.
The last one on the list -- Kidney failure -- wasn't showing.
There were a fixed number of lines.Someone had to shuffle the order of the values so that the various nutritionists, with their hundreds of patients a day, could keep track of what to feed her from then on.She died a few days later.Was it because she'd been underfed for days?
Would feeding her have helped?
I don't know.But the story illustrates how a reasonable assumption made by someone in the chain that you'd need, let's say "four" lines in that field there, could kill someone.Surge suppression seems like a no brainer, but the people making the decisions are not always the people who should be.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209519</id>
	<title>Nothing to see here ... move along....</title>
	<author>johnlcallaway</author>
	<datestamp>1244129820000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext>It sounds like they were not accepting patients that couldn't make it to another hospital. Since they were accepting walk-ins, it's very likely an ambulance with a critical patient would have been accepted. If that was true, no one was being denied healthcare.   Here in Phoenix, it's hard to go 5 miles without seeing another hospital. I was recently in a motorcycle crash and was not taken to the closest hospital because of the type of injury I had and the reputation the hospital had to handle orthopedic type injuries. I was not in a life threatening situation, just a simple fracture of my fibula, and didn't even go into surgery for 24 hours. I could have ridden several hours to another hospital and still have been just fine.
<br> <br>
Hospitals are businesses and have to make money. If they don't get accurate records, they can't bill the insurance companies. While this is an indication of issues with a specific hospital's computer and backup systems and a possible risk with other hospitals, I see no cause for alarm.
<br> <br>
I recently had to go to emergency for severe stomach pains and ended up having my gall bladder taken out.  I had to wait 5 hours for a room because they were 'code purple'.  All beds in hospital and emergency were full.  I hope they were turning away non-critical patients also.  I wouldn't be surprised if this happens far more often than what the news story reported.</htmltext>
<tokenext>It sounds like they were not accepting patients that could n't make it to another hospital .
Since they were accepting walk-ins , it 's very likely an ambulance with a critical patient would have been accepted .
If that was true , no one was being denied healthcare .
Here in Phoenix , it 's hard to go 5 miles without seeing another hospital .
I was recently in a motorcycle crash and was not taken to the closest hospital because of the type of injury I had and the reputation the hospital had to handle orthopedic type injuries .
I was not in a life threatening situation , just a simple fracture of my fibula , and did n't even go into surgery for 24 hours .
I could have ridden several hours to another hospital and still have been just fine .
Hospitals are businesses and have to make money .
If they do n't get accurate records , they ca n't bill the insurance companies .
While this is an indication of issues with a specific hospital 's computer and backup systems and a possible risk with other hospitals , I see no cause for alarm .
I recently had to go to emergency for severe stomach pains and ended up having my gall bladder taken out .
I had to wait 5 hours for a room because they were 'code purple' .
All beds in hospital and emergency were full .
I hope they were turning away non-critical patients also .
I would n't be surprised if this happens far more often than what the news story reported .</tokentext>
<sentencetext>It sounds like they were not accepting patients that couldn't make it to another hospital.
Since they were accepting walk-ins, it's very likely an ambulance with a critical patient would have been accepted.
If that was true, no one was being denied healthcare.
Here in Phoenix, it's hard to go 5 miles without seeing another hospital.
I was recently in a motorcycle crash and was not taken to the closest hospital because of the type of injury I had and the reputation the hospital had to handle orthopedic type injuries.
I was not in a life threatening situation, just a simple fracture of my fibula, and didn't even go into surgery for 24 hours.
I could have ridden several hours to another hospital and still have been just fine.
Hospitals are businesses and have to make money.
If they don't get accurate records, they can't bill the insurance companies.
While this is an indication of issues with a specific hospital's computer and backup systems and a possible risk with other hospitals, I see no cause for alarm.
I recently had to go to emergency for severe stomach pains and ended up having my gall bladder taken out.
I had to wait 5 hours for a room because they were 'code purple'.
All beds in hospital and emergency were full.
I hope they were turning away non-critical patients also.
I wouldn't be surprised if this happens far more often than what the news story reported.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210025</id>
	<title>i have no sympathy or pity</title>
	<author>nimbius</author>
	<datestamp>1244132040000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>2</modscore>
	<htmltext>for this hospital.  any competent facility with an electronic system such as this obviously has a competent IT staff dedicated to a recovery procedure of some sort.  redundant systems, generator backed servers, and perhaps even colocation while new for healthcare IT should be considered.  <br> <br>
if its like every other IT shop, the "budget" was cut and IT got the short end of the stick again.</htmltext>
<tokenext>for this hospital .
any competent facility with an electronic system such as this obviously has a competent IT staff dedicated to a recovery procedure of some sort .
redundant systems , generator backed servers , and perhaps even colocation while new for healthcare IT should be considered .
if its like every other IT shop , the " budget " was cut and IT got the short end of the stick again .</tokentext>
<sentencetext>for this hospital.
any competent facility with an electronic system such as this obviously has a competent IT staff dedicated to a recovery procedure of some sort.
redundant systems, generator backed servers, and perhaps even colocation while new for healthcare IT should be considered.
if its like every other IT shop, the "budget" was cut and IT got the short end of the stick again.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211645</id>
	<title>The Real Reason they turned away patients ...</title>
	<author>gordguide</author>
	<datestamp>1244138580000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>"<nobr> <wbr></nobr>... Because the electronic health records (EHR) system had gone down the prior afternoon -- due to a power surge -- and the backlog of paperwork was no longer tolerable.<nobr> <wbr></nobr>..."</p><p>The key phrase here is "backlog of paperwork". In about a day, the amount of paper records required to meet the data needs of the EHR system overwhelmed the staff.</p><p>It's not about the EHR system going down, or an inability to admit and care for patients via paper forms, because there were paper-based forms to fall back on.</p><p>It was an inability to cope with the sheer volume of information the system demanded. This is a cautionary tale illustrating the vast quantity of data we now collect. The EHR system enables the hospital to collect much, much more data than a paper-based system would have deemed necessary 20 years ago.</p><p>The easy proof is those paper-based systems worked just fine at the time, while collecting the data the EHR wants on paper forms, a system in place for just such an eventuality, is quickly overwhelming.</p></htmltext>
<tokenext>" ... Because the electronic health records ( EHR ) system had gone down the prior afternoon -- due to a power surge -- and the backlog of paperwork was no longer tolerable .
... " The key phrase here is " backlog of paperwork " .
In about a day , the amount of paper records required to meet the data needs of the EHR system overwhelmed the staff.It 's not about the EHR system going down , or an inability to admit and care for patients via paper forms , because there were paper-based forms to fall back on.It was an inability to cope with the sheer volume of information the system demanded .
This is a cautionary tale illustrating the vast quantity of data we now collect .
The EHR system enables the hospital to collect much , much more data than a paper-based system would have deemed necessary 20 years ago.The easy proof is those paper-based systems worked just fine at the time , while collecting the data the EHR wants on paper forms , a system in place for just such an eventuality , is quickly overwhelming .</tokentext>
<sentencetext>" ... Because the electronic health records (EHR) system had gone down the prior afternoon -- due to a power surge -- and the backlog of paperwork was no longer tolerable.
..."The key phrase here is "backlog of paperwork".
In about a day, the amount of paper records required to meet the data needs of the EHR system overwhelmed the staff.It's not about the EHR system going down, or an inability to admit and care for patients via paper forms, because there were paper-based forms to fall back on.It was an inability to cope with the sheer volume of information the system demanded.
This is a cautionary tale illustrating the vast quantity of data we now collect.
The EHR system enables the hospital to collect much, much more data than a paper-based system would have deemed necessary 20 years ago.The easy proof is those paper-based systems worked just fine at the time, while collecting the data the EHR wants on paper forms, a system in place for just such an eventuality, is quickly overwhelming.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209725</id>
	<title>Re:Nurse != Secretary</title>
	<author>OeLeWaPpErKe</author>
	<datestamp>1244130540000</datestamp>
	<modclass>None</modclass>
	<modscore>-1</modscore>
	<htmltext><p>Actually how about eliminating the problem itself ? If the paperwork is overwhelming, with a reasonable minimum workforce present in the hospital, the government (the recipient of said paperwork), needs to accept the fact that there isn't any paperwork, and foot the bill anyway.</p><p>Obviously this will present docters with patients without medical records. But better to be treated a bit worse than not at all.</p><p>Obviously any sort of national healthcare system will preclude having this common-sense approach, as any system that does not make it the responsibility of the patient to ensure medical bills are paid will ration health care ("total health care resources" are limited. Either you let people pay for them, or you ration them). Rationed health care means "no government approval, no healthcare" both in theory and in practice. Unless congress likes unmarked expense reports ala "Something -&gt; $500.000". And I fear that when they're not coming from congress critters (you know the "oops I forgot to pay my taxes" people) they really dislike them.</p><p>Let's not forget the house speaker is a woman that screams (literally) about the need to conserve co2 emissions, but refuses to fly on anything other than a private jet. National healthcare is another way of saying that she's the one deciding whether your cancer gets treated.</p></htmltext>
<tokenext>Actually how about eliminating the problem itself ?
If the paperwork is overwhelming , with a reasonable minimum workforce present in the hospital , the government ( the recipient of said paperwork ) , needs to accept the fact that there is n't any paperwork , and foot the bill anyway.Obviously this will present docters with patients without medical records .
But better to be treated a bit worse than not at all.Obviously any sort of national healthcare system will preclude having this common-sense approach , as any system that does not make it the responsibility of the patient to ensure medical bills are paid will ration health care ( " total health care resources " are limited .
Either you let people pay for them , or you ration them ) .
Rationed health care means " no government approval , no healthcare " both in theory and in practice .
Unless congress likes unmarked expense reports ala " Something - &gt; $ 500.000 " .
And I fear that when they 're not coming from congress critters ( you know the " oops I forgot to pay my taxes " people ) they really dislike them.Let 's not forget the house speaker is a woman that screams ( literally ) about the need to conserve co2 emissions , but refuses to fly on anything other than a private jet .
National healthcare is another way of saying that she 's the one deciding whether your cancer gets treated .</tokentext>
<sentencetext>Actually how about eliminating the problem itself ?
If the paperwork is overwhelming, with a reasonable minimum workforce present in the hospital, the government (the recipient of said paperwork), needs to accept the fact that there isn't any paperwork, and foot the bill anyway.Obviously this will present docters with patients without medical records.
But better to be treated a bit worse than not at all.Obviously any sort of national healthcare system will preclude having this common-sense approach, as any system that does not make it the responsibility of the patient to ensure medical bills are paid will ration health care ("total health care resources" are limited.
Either you let people pay for them, or you ration them).
Rationed health care means "no government approval, no healthcare" both in theory and in practice.
Unless congress likes unmarked expense reports ala "Something -&gt; $500.000".
And I fear that when they're not coming from congress critters (you know the "oops I forgot to pay my taxes" people) they really dislike them.Let's not forget the house speaker is a woman that screams (literally) about the need to conserve co2 emissions, but refuses to fly on anything other than a private jet.
National healthcare is another way of saying that she's the one deciding whether your cancer gets treated.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209415</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28216929</id>
	<title>Re:Two Word Answer: Patient Safety</title>
	<author>winwar</author>
	<datestamp>1244120760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>"...I've discovered that providing good care is entirely about information. If we don't know someone's drug allergies, medical history, and can't effectively communicate between departments, patient safety is impacted."</p><p>It is about GOOD information.  Too much information is not good.  Relying on existing medical information isn't necessarily a good idea either as mistakes are routine.</p><p>"Turning away patients may actually save lives if a hospital is unable to provide communication and medical background for a patient."</p><p>How?  If I currently go to an ER they won't have any information on me anyway.</p></htmltext>
<tokenext>" ...I 've discovered that providing good care is entirely about information .
If we do n't know someone 's drug allergies , medical history , and ca n't effectively communicate between departments , patient safety is impacted .
" It is about GOOD information .
Too much information is not good .
Relying on existing medical information is n't necessarily a good idea either as mistakes are routine .
" Turning away patients may actually save lives if a hospital is unable to provide communication and medical background for a patient. " How ?
If I currently go to an ER they wo n't have any information on me anyway .</tokentext>
<sentencetext>"...I've discovered that providing good care is entirely about information.
If we don't know someone's drug allergies, medical history, and can't effectively communicate between departments, patient safety is impacted.
"It is about GOOD information.
Too much information is not good.
Relying on existing medical information isn't necessarily a good idea either as mistakes are routine.
"Turning away patients may actually save lives if a hospital is unable to provide communication and medical background for a patient."How?
If I currently go to an ER they won't have any information on me anyway.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209501</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209495</id>
	<title>Missing syllables, not comma</title>
	<author>thinker</author>
	<datestamp>1244129760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Hospital Turns Away Ambulances<br>Computers Go Down<br>Go Boom</p></htmltext>
<tokenext>Hospital Turns Away AmbulancesComputers Go DownGo Boom</tokentext>
<sentencetext>Hospital Turns Away AmbulancesComputers Go DownGo Boom</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210141</id>
	<title>Re:A one word answer</title>
	<author>geekoid</author>
	<datestamp>1244132520000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>If they were life and death, thye would have treated them. Not all ambulance are life and death.</p></htmltext>
<tokenext>If they were life and death , thye would have treated them .
Not all ambulance are life and death .</tokentext>
<sentencetext>If they were life and death, thye would have treated them.
Not all ambulance are life and death.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210155</id>
	<title>Re:Nurse != Secretary</title>
	<author>MrMarket</author>
	<datestamp>1244132580000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>2</modscore>
	<htmltext><p>Your statement about Methodists' incompetent management is valid. Every three year's or so they've had some <a href="http://www.google.com/search?q=methodist+herapin&amp;ie=utf-8&amp;oe=utf-8&amp;aq=t&amp;rls=org.mozilla:en-US:official&amp;client=firefox-a" title="google.com"> terrible </a> [google.com] <a href="http://www.google.com/search?hl=en&amp;client=firefox-a&amp;rls=org.mozilla:en-US:official&amp;ei=8eUnSqzBKIi6M5D15OwB&amp;sa=X&amp;oi=spell&amp;resnum=0&amp;ct=result&amp;cd=1&amp;q=methodist+epidural+paralyzed&amp;spell=1" title="google.com">safety</a> [google.com] failures. Quality care is just not a priority for them. </p><p>This is not so much a story about electronic records as much as it is about Methodist keeping up it's infamous safety record.</p></htmltext>
<tokenext>Your statement about Methodists ' incompetent management is valid .
Every three year 's or so they 've had some terrible [ google.com ] safety [ google.com ] failures .
Quality care is just not a priority for them .
This is not so much a story about electronic records as much as it is about Methodist keeping up it 's infamous safety record .</tokentext>
<sentencetext>Your statement about Methodists' incompetent management is valid.
Every three year's or so they've had some  terrible  [google.com] safety [google.com] failures.
Quality care is just not a priority for them.
This is not so much a story about electronic records as much as it is about Methodist keeping up it's infamous safety record.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209753</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209439</id>
	<title>Re:It's Not Just Any Beaurocracy</title>
	<author>swillden</author>
	<datestamp>1244129580000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><blockquote><div><p>Why do problems with paperwork make it necessary to turn away patients?</p></div></blockquote><p>In an ER, "paperwork" includes information on whether they'll kill you if they give you a certain drug or transfusion.  Stuff like that.</p></div><p>In some cases that's true, but not usually.  It's only true if they already have records for the patient, and if they have identified the patient, and if they have bothered to look it up.  The first is often not true and in urgent care situations the second and third are not usually done.  Not until the emergency situation is stabilized, anyway.

If you have an issue that could create serious problems if you were given the wrong drugs, etc., you should get a medic-alert bracelet or similar with the information.  Otherwise, there's a very good chance the ER doctors will have no idea, even if you're at your local hospital.</p></div>
	</htmltext>
<tokenext>Why do problems with paperwork make it necessary to turn away patients ? In an ER , " paperwork " includes information on whether they 'll kill you if they give you a certain drug or transfusion .
Stuff like that.In some cases that 's true , but not usually .
It 's only true if they already have records for the patient , and if they have identified the patient , and if they have bothered to look it up .
The first is often not true and in urgent care situations the second and third are not usually done .
Not until the emergency situation is stabilized , anyway .
If you have an issue that could create serious problems if you were given the wrong drugs , etc. , you should get a medic-alert bracelet or similar with the information .
Otherwise , there 's a very good chance the ER doctors will have no idea , even if you 're at your local hospital .</tokentext>
<sentencetext>Why do problems with paperwork make it necessary to turn away patients?In an ER, "paperwork" includes information on whether they'll kill you if they give you a certain drug or transfusion.
Stuff like that.In some cases that's true, but not usually.
It's only true if they already have records for the patient, and if they have identified the patient, and if they have bothered to look it up.
The first is often not true and in urgent care situations the second and third are not usually done.
Not until the emergency situation is stabilized, anyway.
If you have an issue that could create serious problems if you were given the wrong drugs, etc., you should get a medic-alert bracelet or similar with the information.
Otherwise, there's a very good chance the ER doctors will have no idea, even if you're at your local hospital.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209291</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28213663</id>
	<title>A voice from the inside</title>
	<author>Anonymous</author>
	<datestamp>1244147100000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Big brother may be watching (since I'm in Indianapolis) so this is going up anonymously.  Sorry.<br>---</p><p>Methodist Hospital is a member of Clarian Health Partners, which also manages Indiana University Hospital and Riley Hospital for Children, located about 2 miles away from Methodist Hospital, also in downtown Indianapolis.  Also located in downtown Indy are the Roudebush Veterans Affairs Medical Center (VAMC) and Wishard Memorial Hospital - the county hospital.  Wishard Memorial and Methodist are both Level 1 Trauma Centers (Indiana's only two Level 1 Centers).  Both are staffed primarily by Indiana University faculty physicians or Indiana University graduates.</p><p>Clarian Health Partners uses an implementation of Cerner's Electronic Medical Record system.  Cerner Corp., in Kansas City, provides "support" and roll-out assistance.  In-house support staff seems capable only of basic help - password resets, how to access lab values, etc.  More complex support requests get "sent out" to Cerner.  A response may arrive in hours, days, or never.  The roll-out of the system, from what I have heard and seen, has been plagued by problems.  The roll-out has been phased across the three hospitals... and problems seem to occur on a daily basis.  It's like the system wasn't scalable enough to handle the complexity of three major interconnected hospitals in a metropolitan area.  Physicians and nurses frequently complain that this brand new, multi-million dollar system is slow, unreliable, crashes, and loses "works in progress" when it fails due to the lack of any type of auto-save feature.</p><p>Surprisingly, CPRS (the system used by the VAMC and by all VA hospitals, from what I have heard) is lauded as BETTER than the Cerner system, from the doctors I've heard from who have used both.  Many docs in town work at multiple hospitals, so they have experience with all of the systems.  Even the proprietary in-house system developed at Wishard (the county hospital), and which has been in continuous use since the mid 1990's, is reportedly better than this new 2008-2009 implemented system.  It's unfortunate this happened, but unsurprising.</p><p>Hospitals really need to get physicians, nurses, and unit staff involved when developing and choosing an EMR system.  Unfortunately, it seems like the people who develop these systems or who decide to purchase them are isolated from the needs of the personnel that will use the system.  Something that looks great on a software designer's computer screen may not accommodate the workflow of the staff and physicians when it comes to clinical implementation.  Maybe this was done, maybe it wasn't.</p><p>It's too late to go back now - the system is so entrenched in the three hospitals that it's unlikely it will be replaced in the next decade or two, despite its numerous shortcomings.  The hospitals are at the mercy of Cerner Corporation and their planned "upgrades" in the future.</p><p>If you wonder why hospitals aren't moving to EMR systems more quickly... this is why.  Once one is selected, you're trapped and can't switch without an even larger investment to port the data from one system to the next.  From what I've heard, the commercial EMR systems out there are in their infancy.  They just don't scale - the programmers have minimal insight or skill - and they're kludged together with add-ons and work-arounds to make them fit the hospital's needs.  Someone needs to come out with something that "just works."</p><p>Think Apple will be entering the EMR market anytime soon?  I hope so.</p></htmltext>
<tokenext>Big brother may be watching ( since I 'm in Indianapolis ) so this is going up anonymously .
Sorry.---Methodist Hospital is a member of Clarian Health Partners , which also manages Indiana University Hospital and Riley Hospital for Children , located about 2 miles away from Methodist Hospital , also in downtown Indianapolis .
Also located in downtown Indy are the Roudebush Veterans Affairs Medical Center ( VAMC ) and Wishard Memorial Hospital - the county hospital .
Wishard Memorial and Methodist are both Level 1 Trauma Centers ( Indiana 's only two Level 1 Centers ) .
Both are staffed primarily by Indiana University faculty physicians or Indiana University graduates.Clarian Health Partners uses an implementation of Cerner 's Electronic Medical Record system .
Cerner Corp. , in Kansas City , provides " support " and roll-out assistance .
In-house support staff seems capable only of basic help - password resets , how to access lab values , etc .
More complex support requests get " sent out " to Cerner .
A response may arrive in hours , days , or never .
The roll-out of the system , from what I have heard and seen , has been plagued by problems .
The roll-out has been phased across the three hospitals... and problems seem to occur on a daily basis .
It 's like the system was n't scalable enough to handle the complexity of three major interconnected hospitals in a metropolitan area .
Physicians and nurses frequently complain that this brand new , multi-million dollar system is slow , unreliable , crashes , and loses " works in progress " when it fails due to the lack of any type of auto-save feature.Surprisingly , CPRS ( the system used by the VAMC and by all VA hospitals , from what I have heard ) is lauded as BETTER than the Cerner system , from the doctors I 've heard from who have used both .
Many docs in town work at multiple hospitals , so they have experience with all of the systems .
Even the proprietary in-house system developed at Wishard ( the county hospital ) , and which has been in continuous use since the mid 1990 's , is reportedly better than this new 2008-2009 implemented system .
It 's unfortunate this happened , but unsurprising.Hospitals really need to get physicians , nurses , and unit staff involved when developing and choosing an EMR system .
Unfortunately , it seems like the people who develop these systems or who decide to purchase them are isolated from the needs of the personnel that will use the system .
Something that looks great on a software designer 's computer screen may not accommodate the workflow of the staff and physicians when it comes to clinical implementation .
Maybe this was done , maybe it was n't.It 's too late to go back now - the system is so entrenched in the three hospitals that it 's unlikely it will be replaced in the next decade or two , despite its numerous shortcomings .
The hospitals are at the mercy of Cerner Corporation and their planned " upgrades " in the future.If you wonder why hospitals are n't moving to EMR systems more quickly... this is why .
Once one is selected , you 're trapped and ca n't switch without an even larger investment to port the data from one system to the next .
From what I 've heard , the commercial EMR systems out there are in their infancy .
They just do n't scale - the programmers have minimal insight or skill - and they 're kludged together with add-ons and work-arounds to make them fit the hospital 's needs .
Someone needs to come out with something that " just works .
" Think Apple will be entering the EMR market anytime soon ?
I hope so .</tokentext>
<sentencetext>Big brother may be watching (since I'm in Indianapolis) so this is going up anonymously.
Sorry.---Methodist Hospital is a member of Clarian Health Partners, which also manages Indiana University Hospital and Riley Hospital for Children, located about 2 miles away from Methodist Hospital, also in downtown Indianapolis.
Also located in downtown Indy are the Roudebush Veterans Affairs Medical Center (VAMC) and Wishard Memorial Hospital - the county hospital.
Wishard Memorial and Methodist are both Level 1 Trauma Centers (Indiana's only two Level 1 Centers).
Both are staffed primarily by Indiana University faculty physicians or Indiana University graduates.Clarian Health Partners uses an implementation of Cerner's Electronic Medical Record system.
Cerner Corp., in Kansas City, provides "support" and roll-out assistance.
In-house support staff seems capable only of basic help - password resets, how to access lab values, etc.
More complex support requests get "sent out" to Cerner.
A response may arrive in hours, days, or never.
The roll-out of the system, from what I have heard and seen, has been plagued by problems.
The roll-out has been phased across the three hospitals... and problems seem to occur on a daily basis.
It's like the system wasn't scalable enough to handle the complexity of three major interconnected hospitals in a metropolitan area.
Physicians and nurses frequently complain that this brand new, multi-million dollar system is slow, unreliable, crashes, and loses "works in progress" when it fails due to the lack of any type of auto-save feature.Surprisingly, CPRS (the system used by the VAMC and by all VA hospitals, from what I have heard) is lauded as BETTER than the Cerner system, from the doctors I've heard from who have used both.
Many docs in town work at multiple hospitals, so they have experience with all of the systems.
Even the proprietary in-house system developed at Wishard (the county hospital), and which has been in continuous use since the mid 1990's, is reportedly better than this new 2008-2009 implemented system.
It's unfortunate this happened, but unsurprising.Hospitals really need to get physicians, nurses, and unit staff involved when developing and choosing an EMR system.
Unfortunately, it seems like the people who develop these systems or who decide to purchase them are isolated from the needs of the personnel that will use the system.
Something that looks great on a software designer's computer screen may not accommodate the workflow of the staff and physicians when it comes to clinical implementation.
Maybe this was done, maybe it wasn't.It's too late to go back now - the system is so entrenched in the three hospitals that it's unlikely it will be replaced in the next decade or two, despite its numerous shortcomings.
The hospitals are at the mercy of Cerner Corporation and their planned "upgrades" in the future.If you wonder why hospitals aren't moving to EMR systems more quickly... this is why.
Once one is selected, you're trapped and can't switch without an even larger investment to port the data from one system to the next.
From what I've heard, the commercial EMR systems out there are in their infancy.
They just don't scale - the programmers have minimal insight or skill - and they're kludged together with add-ons and work-arounds to make them fit the hospital's needs.
Someone needs to come out with something that "just works.
"Think Apple will be entering the EMR market anytime soon?
I hope so.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210871</id>
	<title>Re:Patients turned away?</title>
	<author>Anonymous</author>
	<datestamp>1244135400000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>I once worked near Wishard Hospital, it's one of the county hospitals for Indianapolis. There are about 5 hospitals in that area (including a children's hospital and the VA) We used to joke that if we ever got injured on the job to be sure to ask to be taken to Methodist or University Hospital, unless you had a gunshot wound or had been stabbed, then Wishard was the best.</p></htmltext>
<tokenext>I once worked near Wishard Hospital , it 's one of the county hospitals for Indianapolis .
There are about 5 hospitals in that area ( including a children 's hospital and the VA ) We used to joke that if we ever got injured on the job to be sure to ask to be taken to Methodist or University Hospital , unless you had a gunshot wound or had been stabbed , then Wishard was the best .</tokentext>
<sentencetext>I once worked near Wishard Hospital, it's one of the county hospitals for Indianapolis.
There are about 5 hospitals in that area (including a children's hospital and the VA) We used to joke that if we ever got injured on the job to be sure to ask to be taken to Methodist or University Hospital, unless you had a gunshot wound or had been stabbed, then Wishard was the best.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209757</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28215777</id>
	<title>The answer is simple</title>
	<author>popsicle67</author>
	<datestamp>1244114100000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>The answer to the question "Why?" is always Money</htmltext>
<tokenext>The answer to the question " Why ?
" is always Money</tokentext>
<sentencetext>The answer to the question "Why?
" is always Money</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209415</id>
	<title>Re:Nurse != Secretary</title>
	<author>Divebus</author>
	<datestamp>1244129460000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>What happens when The Big One hits? Time for a stress test on hospitals now.</p></htmltext>
<tokenext>What happens when The Big One hits ?
Time for a stress test on hospitals now .</tokentext>
<sentencetext>What happens when The Big One hits?
Time for a stress test on hospitals now.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209217</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28213405</id>
	<title>Re:Nurse != Secretary</title>
	<author>ScentCone</author>
	<datestamp>1244146020000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><i>Because profit is more important than human lives.</i>
<br> <br>
No, because a hospital that is bankrupt can't save <i>any</i> human lives.</htmltext>
<tokenext>Because profit is more important than human lives .
No , because a hospital that is bankrupt ca n't save any human lives .</tokentext>
<sentencetext>Because profit is more important than human lives.
No, because a hospital that is bankrupt can't save any human lives.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209753</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210651</id>
	<title>Wait, a POWER SURGE?</title>
	<author>selven</author>
	<datestamp>1244134620000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>You can't be seriously telling me that critical systems in a hospital that takes in emergency patients are so weak that a single power surge can take them all down? What happened to redundancy?</htmltext>
<tokenext>You ca n't be seriously telling me that critical systems in a hospital that takes in emergency patients are so weak that a single power surge can take them all down ?
What happened to redundancy ?</tokentext>
<sentencetext>You can't be seriously telling me that critical systems in a hospital that takes in emergency patients are so weak that a single power surge can take them all down?
What happened to redundancy?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211329</id>
	<title>it's  so stupid</title>
	<author>Anonymous</author>
	<datestamp>1244137320000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>to replace manual systems with computers to such an extent that business can't be done during a power failure.  Remember back in the day when we were taught how to make change in school and had a real world demonstration of that task every time we went shopping?  It is so stupid for a store not to sell stuff just because its record keeping system is down.
<br> <br>

Emergency rooms can triage so that the obvious cases do get treated there.  It doesn't take long to write or dictate removed splinter from left middle finger and then the name and phone number.  Everything else can be input later.  If the kid is diabetic or something, the parent will probably mention it, especially if reminded.  Maybe this was done, the article didn't say all patents were turned away, did it?
<br> <br>

stores are even easier.  it's not life or death to the customer, he will just go to another stay while the cashiers stand around.  But, barcodes can be scanned (wireless scanner, and if store is smart, the database will have the price, too) and recorded to be uploaded later, and the transaction takes place manually,  The entire stores entire table of sku's and prices can fit on a laptop, as well as a rudimentary cash register program.
<br> <br>

The only time power outage should cause a problem is if doctor/nurse/clerk needs to access information on that particular customer from a previous encounter.  For nobrainers, if a skinned knee can be called a nobrainer, just get the name, phone number, and insurance ID and deal with it later.</htmltext>
<tokenext>to replace manual systems with computers to such an extent that business ca n't be done during a power failure .
Remember back in the day when we were taught how to make change in school and had a real world demonstration of that task every time we went shopping ?
It is so stupid for a store not to sell stuff just because its record keeping system is down .
Emergency rooms can triage so that the obvious cases do get treated there .
It does n't take long to write or dictate removed splinter from left middle finger and then the name and phone number .
Everything else can be input later .
If the kid is diabetic or something , the parent will probably mention it , especially if reminded .
Maybe this was done , the article did n't say all patents were turned away , did it ?
stores are even easier .
it 's not life or death to the customer , he will just go to another stay while the cashiers stand around .
But , barcodes can be scanned ( wireless scanner , and if store is smart , the database will have the price , too ) and recorded to be uploaded later , and the transaction takes place manually , The entire stores entire table of sku 's and prices can fit on a laptop , as well as a rudimentary cash register program .
The only time power outage should cause a problem is if doctor/nurse/clerk needs to access information on that particular customer from a previous encounter .
For nobrainers , if a skinned knee can be called a nobrainer , just get the name , phone number , and insurance ID and deal with it later .</tokentext>
<sentencetext>to replace manual systems with computers to such an extent that business can't be done during a power failure.
Remember back in the day when we were taught how to make change in school and had a real world demonstration of that task every time we went shopping?
It is so stupid for a store not to sell stuff just because its record keeping system is down.
Emergency rooms can triage so that the obvious cases do get treated there.
It doesn't take long to write or dictate removed splinter from left middle finger and then the name and phone number.
Everything else can be input later.
If the kid is diabetic or something, the parent will probably mention it, especially if reminded.
Maybe this was done, the article didn't say all patents were turned away, did it?
stores are even easier.
it's not life or death to the customer, he will just go to another stay while the cashiers stand around.
But, barcodes can be scanned (wireless scanner, and if store is smart, the database will have the price, too) and recorded to be uploaded later, and the transaction takes place manually,  The entire stores entire table of sku's and prices can fit on a laptop, as well as a rudimentary cash register program.
The only time power outage should cause a problem is if doctor/nurse/clerk needs to access information on that particular customer from a previous encounter.
For nobrainers, if a skinned knee can be called a nobrainer, just get the name, phone number, and insurance ID and deal with it later.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210775</id>
	<title>An analogy to our jobs...</title>
	<author>bill\_kress</author>
	<datestamp>1244135100000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>We do backups, but if we never do a restore, we don't really know that the restore procedure will work.  If you REALLY want to make your downtime minimal, you occasionally test your restore procedure.</p><p>I'd like to suggest that any life critical application like this be forced, at least one day a month, to run without computers.</p><p>If it causes them to hire another employee, good--we need more employment.  It should also help them gauge how many extra people they will need to handle a situation where the computer services are unavailable.</p><p>Computers are nice, the internet is nice, email is nice, NONE of these should be required for the normal functioning of a country--it's too big a vulnerability.  We already know the effects of an EMP, do we really want a single attack to be able to shut down all the hospitals in a state?</p></htmltext>
<tokenext>We do backups , but if we never do a restore , we do n't really know that the restore procedure will work .
If you REALLY want to make your downtime minimal , you occasionally test your restore procedure.I 'd like to suggest that any life critical application like this be forced , at least one day a month , to run without computers.If it causes them to hire another employee , good--we need more employment .
It should also help them gauge how many extra people they will need to handle a situation where the computer services are unavailable.Computers are nice , the internet is nice , email is nice , NONE of these should be required for the normal functioning of a country--it 's too big a vulnerability .
We already know the effects of an EMP , do we really want a single attack to be able to shut down all the hospitals in a state ?</tokentext>
<sentencetext>We do backups, but if we never do a restore, we don't really know that the restore procedure will work.
If you REALLY want to make your downtime minimal, you occasionally test your restore procedure.I'd like to suggest that any life critical application like this be forced, at least one day a month, to run without computers.If it causes them to hire another employee, good--we need more employment.
It should also help them gauge how many extra people they will need to handle a situation where the computer services are unavailable.Computers are nice, the internet is nice, email is nice, NONE of these should be required for the normal functioning of a country--it's too big a vulnerability.
We already know the effects of an EMP, do we really want a single attack to be able to shut down all the hospitals in a state?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210509</id>
	<title>Isn't this pretty standard?</title>
	<author>Anonymous</author>
	<datestamp>1244134020000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>On my one and only ambulance ride, instead of going to the closet hospital, I was routed to one that was slightly farther away. The paramedics radioed to dispatch and gave them a synopsis of my conditiona nd outlook, and were told where to go.</p><p>I have no idea what factors played into this decision - probably, availability at the two conditions coupled with the perceived seriousness of my condition. I had a ~5 minute longer ambulance ride and received treatment at a good hospital.</p><p>This is like load balancing. This is simply a sign that ambulance dispatching works WELL - they automatically adjust to compensate for problems that would delay service at a particular hospital.</p></htmltext>
<tokenext>On my one and only ambulance ride , instead of going to the closet hospital , I was routed to one that was slightly farther away .
The paramedics radioed to dispatch and gave them a synopsis of my conditiona nd outlook , and were told where to go.I have no idea what factors played into this decision - probably , availability at the two conditions coupled with the perceived seriousness of my condition .
I had a ~ 5 minute longer ambulance ride and received treatment at a good hospital.This is like load balancing .
This is simply a sign that ambulance dispatching works WELL - they automatically adjust to compensate for problems that would delay service at a particular hospital .</tokentext>
<sentencetext>On my one and only ambulance ride, instead of going to the closet hospital, I was routed to one that was slightly farther away.
The paramedics radioed to dispatch and gave them a synopsis of my conditiona nd outlook, and were told where to go.I have no idea what factors played into this decision - probably, availability at the two conditions coupled with the perceived seriousness of my condition.
I had a ~5 minute longer ambulance ride and received treatment at a good hospital.This is like load balancing.
This is simply a sign that ambulance dispatching works WELL - they automatically adjust to compensate for problems that would delay service at a particular hospital.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209553</id>
	<title>It's here!</title>
	<author>DarrenBaker</author>
	<datestamp>1244130000000</datestamp>
	<modclass>Funny</modclass>
	<modscore>2</modscore>
	<htmltext><p>I've been waiting for this news for years. Computers that perform fellatio? YES!</p><p>Imagine a beowulf cluster of those...</p></htmltext>
<tokenext>I 've been waiting for this news for years .
Computers that perform fellatio ?
YES ! Imagine a beowulf cluster of those.. .</tokentext>
<sentencetext>I've been waiting for this news for years.
Computers that perform fellatio?
YES!Imagine a beowulf cluster of those...</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28213471</id>
	<title>From TFS</title>
	<author>SBrach</author>
	<datestamp>1244146260000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>100+History=Lack of Proof-reading Skills</htmltext>
<tokenext>100 + History = Lack of Proof-reading Skills</tokentext>
<sentencetext>100+History=Lack of Proof-reading Skills</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209993</id>
	<title>Workflow</title>
	<author>bzzfzz</author>
	<datestamp>1244131980000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext><p>The problem is not so much access to historical records in these situations as it is workflow.  After all, a patient sent to another hospital will not have the benefit of medical history records created at another hospital or clinic.
</p><p>Workflow is where there is trouble.  If you're reading this you probably use a GPS or Google maps to get around, probably both.  Do you still have any paper roadmaps?  I don't.  Your process for getting to a new place depends on the technology.  Same with hospitals.  They increasingly depend on automated workflows for scheduling, for dispensing drugs, for managing lab and x-ray orders and results, and so on.</p><p>Hospitals have switched to these systems because they require fewer staff.  They have largely dismantled the paper+clipboard+courier systems that preceded them.  These older systems were complex and cannot be resurrected quickly. There aren't enough people to implement them.  The institutional memory on how to use them is lost.</p><p>I would guess that, in this particular case, they've gone back to paper prescriptions, signed by doctors, and taken by courier to the pharmacy, with a paper label on the dispensed drugs.  That must be scary, because all the safeguards in the automated system -- checks for allergies, interactions, appropriate dosage for patient weight, not to mention barcode scans at multiple points to guard against mistakes -- are gone.  Who will do the manual crosschecking?  Have they been trained?</p><p>As Isaac Asimov once wrote, ""I do not fear computers. I fear the lack of them."</p></htmltext>
<tokenext>The problem is not so much access to historical records in these situations as it is workflow .
After all , a patient sent to another hospital will not have the benefit of medical history records created at another hospital or clinic .
Workflow is where there is trouble .
If you 're reading this you probably use a GPS or Google maps to get around , probably both .
Do you still have any paper roadmaps ?
I do n't .
Your process for getting to a new place depends on the technology .
Same with hospitals .
They increasingly depend on automated workflows for scheduling , for dispensing drugs , for managing lab and x-ray orders and results , and so on.Hospitals have switched to these systems because they require fewer staff .
They have largely dismantled the paper + clipboard + courier systems that preceded them .
These older systems were complex and can not be resurrected quickly .
There are n't enough people to implement them .
The institutional memory on how to use them is lost.I would guess that , in this particular case , they 've gone back to paper prescriptions , signed by doctors , and taken by courier to the pharmacy , with a paper label on the dispensed drugs .
That must be scary , because all the safeguards in the automated system -- checks for allergies , interactions , appropriate dosage for patient weight , not to mention barcode scans at multiple points to guard against mistakes -- are gone .
Who will do the manual crosschecking ?
Have they been trained ? As Isaac Asimov once wrote , " " I do not fear computers .
I fear the lack of them .
"</tokentext>
<sentencetext>The problem is not so much access to historical records in these situations as it is workflow.
After all, a patient sent to another hospital will not have the benefit of medical history records created at another hospital or clinic.
Workflow is where there is trouble.
If you're reading this you probably use a GPS or Google maps to get around, probably both.
Do you still have any paper roadmaps?
I don't.
Your process for getting to a new place depends on the technology.
Same with hospitals.
They increasingly depend on automated workflows for scheduling, for dispensing drugs, for managing lab and x-ray orders and results, and so on.Hospitals have switched to these systems because they require fewer staff.
They have largely dismantled the paper+clipboard+courier systems that preceded them.
These older systems were complex and cannot be resurrected quickly.
There aren't enough people to implement them.
The institutional memory on how to use them is lost.I would guess that, in this particular case, they've gone back to paper prescriptions, signed by doctors, and taken by courier to the pharmacy, with a paper label on the dispensed drugs.
That must be scary, because all the safeguards in the automated system -- checks for allergies, interactions, appropriate dosage for patient weight, not to mention barcode scans at multiple points to guard against mistakes -- are gone.
Who will do the manual crosschecking?
Have they been trained?As Isaac Asimov once wrote, ""I do not fear computers.
I fear the lack of them.
"</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212085</id>
	<title>preparedness?</title>
	<author>Anonymous</author>
	<datestamp>1244140680000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>It's good to be able to take advantage of technology, but you should always be prepared to do the work without it. This is especially important in hospitals. The only thing is that hospitals are least likely to think of this as a problem because they usually have their power on a separate grid.</p></htmltext>
<tokenext>It 's good to be able to take advantage of technology , but you should always be prepared to do the work without it .
This is especially important in hospitals .
The only thing is that hospitals are least likely to think of this as a problem because they usually have their power on a separate grid .</tokentext>
<sentencetext>It's good to be able to take advantage of technology, but you should always be prepared to do the work without it.
This is especially important in hospitals.
The only thing is that hospitals are least likely to think of this as a problem because they usually have their power on a separate grid.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210253</id>
	<title>Re:Nurse != Secretary</title>
	<author>plague3106</author>
	<datestamp>1244132940000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext><p><i>Obviously this will present docters with patients without medical records. But better to be treated a bit worse than not at all.</i></p><p>Ya, until you go back to the hosipital and the next doctor on staff doesn't know the dosage of medication you were put on, and gives you something that shouldn't be combined with the previous medication.</p></htmltext>
<tokenext>Obviously this will present docters with patients without medical records .
But better to be treated a bit worse than not at all.Ya , until you go back to the hosipital and the next doctor on staff does n't know the dosage of medication you were put on , and gives you something that should n't be combined with the previous medication .</tokentext>
<sentencetext>Obviously this will present docters with patients without medical records.
But better to be treated a bit worse than not at all.Ya, until you go back to the hosipital and the next doctor on staff doesn't know the dosage of medication you were put on, and gives you something that shouldn't be combined with the previous medication.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209725</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28225253</id>
	<title>Admin paperwork /= patient care paperwork.</title>
	<author>Skip Morris</author>
	<datestamp>1244227560000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>You're confusing administrative paperwork with that required for patient care.</p><p>At the hospital I worked at in the IT department; when the system/network/EMR went down the hospital ran on various backup methods.</p><p>The pharmacy (for example), switched to using fax machines to process perscriptions. Then delivery by hand instead of computer controlled robot.  With the system down the capacity of the pharmacy to fill and deliver perscriptions dropped.</p><p>And of course the EMR system took care to verify dosage, drug interactions, allergies, etc.</p><p>Or how about radiology? Normally x-rays are distributed electronically so any provider in the hospital can quickly access patient records.  Using a backup system that provides actual film?  Takes longer, and is much more work.  A doctor wants to consult a specialist across the other side of the hospital?  Someone now has to hand-carry the x-ray and get bring back a hand-written summary.  Things that used to take seconds or minutes now take minutes to hours.</p><p>When the EMR goes down, the resultant loss in hospital productivity cuts down on the number of patients the hospital can treat.  The paper backup systems just can't keep up with the electronic versions.  Billing can wait, but patient care cannot.</p></htmltext>
<tokenext>You 're confusing administrative paperwork with that required for patient care.At the hospital I worked at in the IT department ; when the system/network/EMR went down the hospital ran on various backup methods.The pharmacy ( for example ) , switched to using fax machines to process perscriptions .
Then delivery by hand instead of computer controlled robot .
With the system down the capacity of the pharmacy to fill and deliver perscriptions dropped.And of course the EMR system took care to verify dosage , drug interactions , allergies , etc.Or how about radiology ?
Normally x-rays are distributed electronically so any provider in the hospital can quickly access patient records .
Using a backup system that provides actual film ?
Takes longer , and is much more work .
A doctor wants to consult a specialist across the other side of the hospital ?
Someone now has to hand-carry the x-ray and get bring back a hand-written summary .
Things that used to take seconds or minutes now take minutes to hours.When the EMR goes down , the resultant loss in hospital productivity cuts down on the number of patients the hospital can treat .
The paper backup systems just ca n't keep up with the electronic versions .
Billing can wait , but patient care can not .</tokentext>
<sentencetext>You're confusing administrative paperwork with that required for patient care.At the hospital I worked at in the IT department; when the system/network/EMR went down the hospital ran on various backup methods.The pharmacy (for example), switched to using fax machines to process perscriptions.
Then delivery by hand instead of computer controlled robot.
With the system down the capacity of the pharmacy to fill and deliver perscriptions dropped.And of course the EMR system took care to verify dosage, drug interactions, allergies, etc.Or how about radiology?
Normally x-rays are distributed electronically so any provider in the hospital can quickly access patient records.
Using a backup system that provides actual film?
Takes longer, and is much more work.
A doctor wants to consult a specialist across the other side of the hospital?
Someone now has to hand-carry the x-ray and get bring back a hand-written summary.
Things that used to take seconds or minutes now take minutes to hours.When the EMR goes down, the resultant loss in hospital productivity cuts down on the number of patients the hospital can treat.
The paper backup systems just can't keep up with the electronic versions.
Billing can wait, but patient care cannot.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28213713</id>
	<title>Well it probably had more to do with...</title>
	<author>JumpDrive</author>
	<datestamp>1244147280000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>This probably had more to do with the doctors not being able to get on WebMD.</htmltext>
<tokenext>This probably had more to do with the doctors not being able to get on WebMD .</tokentext>
<sentencetext>This probably had more to do with the doctors not being able to get on WebMD.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209457</id>
	<title>Re:It's Not Just Any Beaurocracy</title>
	<author>MasseKid</author>
	<datestamp>1244129580000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Yeah cause they killed all kinds of people before 1990 when all they had was paper.</htmltext>
<tokenext>Yeah cause they killed all kinds of people before 1990 when all they had was paper .</tokentext>
<sentencetext>Yeah cause they killed all kinds of people before 1990 when all they had was paper.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209291</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211167</id>
	<title>Re:Two Word Answer: Patient Safety</title>
	<author>Reziac</author>
	<datestamp>1244136660000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>If someone just arrived in the ambulance and is obviously in bad shape, you may not have time to wait for those records or digest their import. But it seems now that making a good educated guess with a high probability of saving a life takes a back seat to being sure of avoiding all possible mistakes.</p><p>I wonder if anyone died because of this incident, simply because they didn't get treatment in time.</p></htmltext>
<tokenext>If someone just arrived in the ambulance and is obviously in bad shape , you may not have time to wait for those records or digest their import .
But it seems now that making a good educated guess with a high probability of saving a life takes a back seat to being sure of avoiding all possible mistakes.I wonder if anyone died because of this incident , simply because they did n't get treatment in time .</tokentext>
<sentencetext>If someone just arrived in the ambulance and is obviously in bad shape, you may not have time to wait for those records or digest their import.
But it seems now that making a good educated guess with a high probability of saving a life takes a back seat to being sure of avoiding all possible mistakes.I wonder if anyone died because of this incident, simply because they didn't get treatment in time.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209501</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211857</id>
	<title>Re:In need of a form cycle system</title>
	<author>Anonymous</author>
	<datestamp>1244139660000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext>I hope that the hospital you work for doesn't allow you to write anything seen by anyone outside of the hospital. Spell checking is integrated in almost all browser text input fields anymore. Why don't you pay attention to the little red squiggles?</htmltext>
<tokenext>I hope that the hospital you work for does n't allow you to write anything seen by anyone outside of the hospital .
Spell checking is integrated in almost all browser text input fields anymore .
Why do n't you pay attention to the little red squiggles ?</tokentext>
<sentencetext>I hope that the hospital you work for doesn't allow you to write anything seen by anyone outside of the hospital.
Spell checking is integrated in almost all browser text input fields anymore.
Why don't you pay attention to the little red squiggles?</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209367</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210017</id>
	<title>Be thankful for computers</title>
	<author>davidwr</author>
	<datestamp>1244132040000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>If a hospital can only process paperwork for X patients per hour, then it can only accept X patients per hour without getting a backlog.</p><p>If the paperwork is messed up or not available it can lead to medical errors, including fatal ones.</p><p>If computers turn X into 10X or 20X, then great, paperwork is no longer the limiting factor on capacity.  Well, not until the computers crash.</p></htmltext>
<tokenext>If a hospital can only process paperwork for X patients per hour , then it can only accept X patients per hour without getting a backlog.If the paperwork is messed up or not available it can lead to medical errors , including fatal ones.If computers turn X into 10X or 20X , then great , paperwork is no longer the limiting factor on capacity .
Well , not until the computers crash .</tokentext>
<sentencetext>If a hospital can only process paperwork for X patients per hour, then it can only accept X patients per hour without getting a backlog.If the paperwork is messed up or not available it can lead to medical errors, including fatal ones.If computers turn X into 10X or 20X, then great, paperwork is no longer the limiting factor on capacity.
Well, not until the computers crash.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28223497</id>
	<title>this is not a science story</title>
	<author>PJ6</author>
	<datestamp>1244220840000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Why is this story in the science category? It has nothing to do with science.</htmltext>
<tokenext>Why is this story in the science category ?
It has nothing to do with science .</tokentext>
<sentencetext>Why is this story in the science category?
It has nothing to do with science.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209291</id>
	<title>It's Not Just Any Beaurocracy</title>
	<author>Anonymous</author>
	<datestamp>1244129040000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>5</modscore>
	<htmltext><blockquote><div><p>Why do problems with paperwork make it necessary to turn away patients?</p></div></blockquote><p>In an ER, "paperwork" includes information on whether they'll kill you if they give you a certain drug or transfusion.  Stuff like that.</p></div>
	</htmltext>
<tokenext>Why do problems with paperwork make it necessary to turn away patients ? In an ER , " paperwork " includes information on whether they 'll kill you if they give you a certain drug or transfusion .
Stuff like that .</tokentext>
<sentencetext>Why do problems with paperwork make it necessary to turn away patients?In an ER, "paperwork" includes information on whether they'll kill you if they give you a certain drug or transfusion.
Stuff like that.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28214567</id>
	<title>Re:Let me see....</title>
	<author>Anonymous</author>
	<datestamp>1244107920000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext>Away Ambulances... how "Trek" of you.</htmltext>
<tokenext>Away Ambulances... how " Trek " of you .</tokentext>
<sentencetext>Away Ambulances... how "Trek" of you.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209677</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210487</id>
	<title>That's what I hate about Methodist Hospital</title>
	<author>Locke2005</author>
	<datestamp>1244133900000</datestamp>
	<modclass>Troll</modclass>
	<modscore>0</modscore>
	<htmltext>The computers go down, but the nurses don't.</htmltext>
<tokenext>The computers go down , but the nurses do n't .</tokentext>
<sentencetext>The computers go down, but the nurses don't.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210855</id>
	<title>Re:Nurse != Secretary</title>
	<author>Anonymous</author>
	<datestamp>1244135340000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Not insightful at all. Hospitals have to get paid for all of the resources that are employed. Healthcare isn't free, and if you think that there's a dichotomy between billing solely equals profit, you are sadly mistaken.</p></htmltext>
<tokenext>Not insightful at all .
Hospitals have to get paid for all of the resources that are employed .
Healthcare is n't free , and if you think that there 's a dichotomy between billing solely equals profit , you are sadly mistaken .</tokentext>
<sentencetext>Not insightful at all.
Hospitals have to get paid for all of the resources that are employed.
Healthcare isn't free, and if you think that there's a dichotomy between billing solely equals profit, you are sadly mistaken.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209753</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28213651</id>
	<title>health care reform</title>
	<author>d0n0vAn</author>
	<datestamp>1244147040000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>the health care system today has price floors (union contracted wages), price ceilings (usual and customary rate), the removal of the individual being able to negotiate a better price (hmo legislation from 1970s), and mandated electronic locks on everything (hippa). all i hear is it's broken and when are we gonna fix it? jesus h christ, congress has been 'fixing' it longer than i have been alive! when are you going to wake up?</htmltext>
<tokenext>the health care system today has price floors ( union contracted wages ) , price ceilings ( usual and customary rate ) , the removal of the individual being able to negotiate a better price ( hmo legislation from 1970s ) , and mandated electronic locks on everything ( hippa ) .
all i hear is it 's broken and when are we gon na fix it ?
jesus h christ , congress has been 'fixing ' it longer than i have been alive !
when are you going to wake up ?</tokentext>
<sentencetext>the health care system today has price floors (union contracted wages), price ceilings (usual and customary rate), the removal of the individual being able to negotiate a better price (hmo legislation from 1970s), and mandated electronic locks on everything (hippa).
all i hear is it's broken and when are we gonna fix it?
jesus h christ, congress has been 'fixing' it longer than i have been alive!
when are you going to wake up?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209525</id>
	<title>Re:A one word answer</title>
	<author>ILongForDarkness</author>
	<datestamp>1244129880000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>2</modscore>
	<htmltext>Patient safety is another one. If you can't keep up with the paperwork then the next doctor that sees the patient has no idea what drugs were given, etc. Without all the facts available, diagnosis and treatment go out the window.</htmltext>
<tokenext>Patient safety is another one .
If you ca n't keep up with the paperwork then the next doctor that sees the patient has no idea what drugs were given , etc .
Without all the facts available , diagnosis and treatment go out the window .</tokentext>
<sentencetext>Patient safety is another one.
If you can't keep up with the paperwork then the next doctor that sees the patient has no idea what drugs were given, etc.
Without all the facts available, diagnosis and treatment go out the window.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209571</id>
	<title>This is why...</title>
	<author>dburkland</author>
	<datestamp>1244130060000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>We need socialized medicine so the reliable Government can run the industry! Oh wait...</htmltext>
<tokenext>We need socialized medicine so the reliable Government can run the industry !
Oh wait.. .</tokentext>
<sentencetext>We need socialized medicine so the reliable Government can run the industry!
Oh wait...</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210409</id>
	<title>Re:Nurse != Secretary</title>
	<author>QuantumRiff</author>
	<datestamp>1244133660000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Actually, in large cities with more then one hospital, it is common to request the ambulances not come to your hospital for many reasons..

If the patient looks like they need an MRI (or other big, expensive equipment) and yours is down for maintenance...
If your emergency room is too full to handle them properly. (and the others would be faster for the patient)
If the other hospital has certain specialists that might be needed,
etc.</htmltext>
<tokenext>Actually , in large cities with more then one hospital , it is common to request the ambulances not come to your hospital for many reasons. . If the patient looks like they need an MRI ( or other big , expensive equipment ) and yours is down for maintenance.. . If your emergency room is too full to handle them properly .
( and the others would be faster for the patient ) If the other hospital has certain specialists that might be needed , etc .</tokentext>
<sentencetext>Actually, in large cities with more then one hospital, it is common to request the ambulances not come to your hospital for many reasons..

If the patient looks like they need an MRI (or other big, expensive equipment) and yours is down for maintenance...
If your emergency room is too full to handle them properly.
(and the others would be faster for the patient)
If the other hospital has certain specialists that might be needed,
etc.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209753</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210991</id>
	<title>Re:A one word answer</title>
	<author>ISoldat53</author>
	<datestamp>1244135940000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Can't make money without paperwork!</htmltext>
<tokenext>Ca n't make money without paperwork !</tokentext>
<sentencetext>Can't make money without paperwork!</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210045</id>
	<title>I work in the Electronic Records Industry</title>
	<author>Anonymous</author>
	<datestamp>1244132160000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>I work for an ePCR company that was developed and started by Critical Care Flight Nurses/Paramedics.  Our company's main product is the Providers (First Responders) portion of the patient tracking.  When they put in a trip, the hospital gets it immediately.  Further, we have a program that regions use that changes a hospitals status from open to divert when the hospital has issues or is overly crowded.  This happens more than most know.  Divert status warns the EMS Providers ahead of time so that they dont waste minutes hauling a patient to a closed ER.  As one poster stated, this is actually saving the patient's life in many cases.  Our company does not handle medical records of any hospital though.</p></htmltext>
<tokenext>I work for an ePCR company that was developed and started by Critical Care Flight Nurses/Paramedics .
Our company 's main product is the Providers ( First Responders ) portion of the patient tracking .
When they put in a trip , the hospital gets it immediately .
Further , we have a program that regions use that changes a hospitals status from open to divert when the hospital has issues or is overly crowded .
This happens more than most know .
Divert status warns the EMS Providers ahead of time so that they dont waste minutes hauling a patient to a closed ER .
As one poster stated , this is actually saving the patient 's life in many cases .
Our company does not handle medical records of any hospital though .</tokentext>
<sentencetext>I work for an ePCR company that was developed and started by Critical Care Flight Nurses/Paramedics.
Our company's main product is the Providers (First Responders) portion of the patient tracking.
When they put in a trip, the hospital gets it immediately.
Further, we have a program that regions use that changes a hospitals status from open to divert when the hospital has issues or is overly crowded.
This happens more than most know.
Divert status warns the EMS Providers ahead of time so that they dont waste minutes hauling a patient to a closed ER.
As one poster stated, this is actually saving the patient's life in many cases.
Our company does not handle medical records of any hospital though.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209501</id>
	<title>Two Word Answer: Patient Safety</title>
	<author>PIPBoy3000</author>
	<datestamp>1244129760000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>4</modscore>
	<htmltext>As someone who works in healthcare, I've discovered that providing good care is entirely about information.  If we don't know someone's drug allergies, medical history, and can't effectively communicate between departments, patient safety is impacted.  Turning away patients may actually save lives if a hospital is unable to provide communication and medical background for a patient.
<br> <br>
When I'm unable to get to the network for some reason, I feel extra stupid as a developer.  I can't search for code examples on Google, migrate code to staging servers, and so on.  Healthcare is similar, with providers not being as effective as if they had their full EMR at their fingertips.
<br> <br>
Turning away patients results in loss of income, so they're basically losing money in order to improve the safety of their patients.</htmltext>
<tokenext>As someone who works in healthcare , I 've discovered that providing good care is entirely about information .
If we do n't know someone 's drug allergies , medical history , and ca n't effectively communicate between departments , patient safety is impacted .
Turning away patients may actually save lives if a hospital is unable to provide communication and medical background for a patient .
When I 'm unable to get to the network for some reason , I feel extra stupid as a developer .
I ca n't search for code examples on Google , migrate code to staging servers , and so on .
Healthcare is similar , with providers not being as effective as if they had their full EMR at their fingertips .
Turning away patients results in loss of income , so they 're basically losing money in order to improve the safety of their patients .</tokentext>
<sentencetext>As someone who works in healthcare, I've discovered that providing good care is entirely about information.
If we don't know someone's drug allergies, medical history, and can't effectively communicate between departments, patient safety is impacted.
Turning away patients may actually save lives if a hospital is unable to provide communication and medical background for a patient.
When I'm unable to get to the network for some reason, I feel extra stupid as a developer.
I can't search for code examples on Google, migrate code to staging servers, and so on.
Healthcare is similar, with providers not being as effective as if they had their full EMR at their fingertips.
Turning away patients results in loss of income, so they're basically losing money in order to improve the safety of their patients.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209479</id>
	<title>Not a huge deal</title>
	<author>Anonymous</author>
	<datestamp>1244129700000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>4</modscore>
	<htmltext>The summary is a bit sensationalist.  Being a resident of Indianapolis, I know for a fact that there are a ton of hospitals around this area.  Chances are St. Vincent's got a lot of those patients.  I'm certain that Methodist would not have turned away any patients that they were not absolutely certain would receive adequate aid at another hospital, or if they thought that the patient in question was in no condition to be re-routed.<br> <br>

As for paper vs. electronic records, hospitals keep both.  The point is that paper records take a lot longer to manage, and if they can safely do so, it's in everyone's best interest for them to send patients to other hospitals in order to get caught up on paperwork.  If their paperwork keeps piling up, the chances of losing important data increase by a large margin, and that's bad for all parties involved.<br> <br>

No, I say that Methodist made the right call here.</htmltext>
<tokenext>The summary is a bit sensationalist .
Being a resident of Indianapolis , I know for a fact that there are a ton of hospitals around this area .
Chances are St. Vincent 's got a lot of those patients .
I 'm certain that Methodist would not have turned away any patients that they were not absolutely certain would receive adequate aid at another hospital , or if they thought that the patient in question was in no condition to be re-routed .
As for paper vs. electronic records , hospitals keep both .
The point is that paper records take a lot longer to manage , and if they can safely do so , it 's in everyone 's best interest for them to send patients to other hospitals in order to get caught up on paperwork .
If their paperwork keeps piling up , the chances of losing important data increase by a large margin , and that 's bad for all parties involved .
No , I say that Methodist made the right call here .</tokentext>
<sentencetext>The summary is a bit sensationalist.
Being a resident of Indianapolis, I know for a fact that there are a ton of hospitals around this area.
Chances are St. Vincent's got a lot of those patients.
I'm certain that Methodist would not have turned away any patients that they were not absolutely certain would receive adequate aid at another hospital, or if they thought that the patient in question was in no condition to be re-routed.
As for paper vs. electronic records, hospitals keep both.
The point is that paper records take a lot longer to manage, and if they can safely do so, it's in everyone's best interest for them to send patients to other hospitals in order to get caught up on paperwork.
If their paperwork keeps piling up, the chances of losing important data increase by a large margin, and that's bad for all parties involved.
No, I say that Methodist made the right call here.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210433</id>
	<title>Methodist</title>
	<author>maharvey</author>
	<datestamp>1244133720000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>I guess their administrative <em>METHOD IS T</em>oo inflexible.</p></htmltext>
<tokenext>I guess their administrative METHOD IS Too inflexible .</tokentext>
<sentencetext>I guess their administrative METHOD IS Too inflexible.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28213213</id>
	<title>Re:A one word answer</title>
	<author>Hadlock</author>
	<datestamp>1244145300000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Where's the flag for "sensationalist story"? Obviously they will take a patient with life threatening injuries. I have no problem with they rejecting a patient coming in an ambulance who only has a sprained ankle or a mild case of the flu. Rejecting a patient with a gunshot wound or who has flatlined  based on paperwork is different.</p></htmltext>
<tokenext>Where 's the flag for " sensationalist story " ?
Obviously they will take a patient with life threatening injuries .
I have no problem with they rejecting a patient coming in an ambulance who only has a sprained ankle or a mild case of the flu .
Rejecting a patient with a gunshot wound or who has flatlined based on paperwork is different .</tokentext>
<sentencetext>Where's the flag for "sensationalist story"?
Obviously they will take a patient with life threatening injuries.
I have no problem with they rejecting a patient coming in an ambulance who only has a sprained ankle or a mild case of the flu.
Rejecting a patient with a gunshot wound or who has flatlined  based on paperwork is different.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210175</id>
	<title>That doesn't make sense to me</title>
	<author>HangingChad</author>
	<datestamp>1244132640000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>They could certainly use standard word processor documents to keep track of patient information.  Or copy off some of the old paper forms.  How hard is that?

</p><p>The only reason I can see for not treating patients is that they couldn't validate insurance coverage.  Prescriptions can still be written on paper, treatment notes made on paper charts.  For a majority of doctors offices, just ePrescribing is a huge technology step.  The medical field is never far from their paper roots, so I'd have to vote that this was a financial decision.  Delaying treatment because your computers are down?  Come on.</p></htmltext>
<tokenext>They could certainly use standard word processor documents to keep track of patient information .
Or copy off some of the old paper forms .
How hard is that ?
The only reason I can see for not treating patients is that they could n't validate insurance coverage .
Prescriptions can still be written on paper , treatment notes made on paper charts .
For a majority of doctors offices , just ePrescribing is a huge technology step .
The medical field is never far from their paper roots , so I 'd have to vote that this was a financial decision .
Delaying treatment because your computers are down ?
Come on .</tokentext>
<sentencetext>They could certainly use standard word processor documents to keep track of patient information.
Or copy off some of the old paper forms.
How hard is that?
The only reason I can see for not treating patients is that they couldn't validate insurance coverage.
Prescriptions can still be written on paper, treatment notes made on paper charts.
For a majority of doctors offices, just ePrescribing is a huge technology step.
The medical field is never far from their paper roots, so I'd have to vote that this was a financial decision.
Delaying treatment because your computers are down?
Come on.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28215629</id>
	<title>what's the problem?</title>
	<author>z-j-y</author>
	<datestamp>1244113200000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>one node in a distributed system is malfunctioning, requests are re-routed to other nodes. what are you bitching about again? maybe you have a perfect utopia system, why don't you just let it out loud?</p></htmltext>
<tokenext>one node in a distributed system is malfunctioning , requests are re-routed to other nodes .
what are you bitching about again ?
maybe you have a perfect utopia system , why do n't you just let it out loud ?</tokentext>
<sentencetext>one node in a distributed system is malfunctioning, requests are re-routed to other nodes.
what are you bitching about again?
maybe you have a perfect utopia system, why don't you just let it out loud?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211313</id>
	<title>Paper records eventually have to be entered</title>
	<author>phleb3</author>
	<datestamp>1244137260000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>The problem is that all that the manual paper work for each patient is enormous, because it covers all blood tests, all doctors and nurses observations, and little things like patient supplies. All this paper work has to be entered into the computer when it comes back up so that the billing cycle can run. Even a couple of hours of downtime can slow patient care down, and you need the a lot of staff to enter all the manual paperwork when the computer comes back up. When you think that a simple blood test may have 20+ values you see that this may be a problem.</htmltext>
<tokenext>The problem is that all that the manual paper work for each patient is enormous , because it covers all blood tests , all doctors and nurses observations , and little things like patient supplies .
All this paper work has to be entered into the computer when it comes back up so that the billing cycle can run .
Even a couple of hours of downtime can slow patient care down , and you need the a lot of staff to enter all the manual paperwork when the computer comes back up .
When you think that a simple blood test may have 20 + values you see that this may be a problem .</tokentext>
<sentencetext>The problem is that all that the manual paper work for each patient is enormous, because it covers all blood tests, all doctors and nurses observations, and little things like patient supplies.
All this paper work has to be entered into the computer when it comes back up so that the billing cycle can run.
Even a couple of hours of downtime can slow patient care down, and you need the a lot of staff to enter all the manual paperwork when the computer comes back up.
When you think that a simple blood test may have 20+ values you see that this may be a problem.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209757</id>
	<title>Patients turned away?</title>
	<author>vantar</author>
	<datestamp>1244130780000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>4</modscore>
	<htmltext>Since the article is making such a big deal about the rerouting of patients I would like to point out that the the nearest other hospital was Wishard Memorial Hospital, 1.5 miles away as the car drives.(Source:Google Maps)
Its not like patients were being denied treatment because of this problem.</htmltext>
<tokenext>Since the article is making such a big deal about the rerouting of patients I would like to point out that the the nearest other hospital was Wishard Memorial Hospital , 1.5 miles away as the car drives .
( Source : Google Maps ) Its not like patients were being denied treatment because of this problem .</tokentext>
<sentencetext>Since the article is making such a big deal about the rerouting of patients I would like to point out that the the nearest other hospital was Wishard Memorial Hospital, 1.5 miles away as the car drives.
(Source:Google Maps)
Its not like patients were being denied treatment because of this problem.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209435</id>
	<title>EMR</title>
	<author>ljaszcza</author>
	<datestamp>1244129520000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext>I do IT for a small multispeciality group. This story really points out some problems I've seen.

We are in a small town, we have surges, brownouts, you name it. I occasionally have problems even though all my racks are behind decent APC UPSes/conditioners. Inevitably though, spring and fall we have storms and people fire up their AC and the power grid is for crap.
I've tried to work with the utility company but they *deny everything*. At this point I am thinking of getting management involved and pulling together a group of merchants who are IT heavy and petitioning the utility directly or through the state. I do worry about the repercussions though.

As far as EMR goes, we use redundant systems, offsite backup but with imaging we have well over a TB of data. If the system were to go completely fubar, I don't know what would happen. Critical info like allergic reactions, med lists, would be unavailable. We won't even go into billing. For a small four physician group like ours, we could make do I suppose. For a large hospital in a litigious part of the country? I don't know.

I suppose the answer is updatable RFIDs in every citizen so that medical info can travel with and be available with the patient, right? Welcome to the future everyone.</htmltext>
<tokenext>I do IT for a small multispeciality group .
This story really points out some problems I 've seen .
We are in a small town , we have surges , brownouts , you name it .
I occasionally have problems even though all my racks are behind decent APC UPSes/conditioners .
Inevitably though , spring and fall we have storms and people fire up their AC and the power grid is for crap .
I 've tried to work with the utility company but they * deny everything * .
At this point I am thinking of getting management involved and pulling together a group of merchants who are IT heavy and petitioning the utility directly or through the state .
I do worry about the repercussions though .
As far as EMR goes , we use redundant systems , offsite backup but with imaging we have well over a TB of data .
If the system were to go completely fubar , I do n't know what would happen .
Critical info like allergic reactions , med lists , would be unavailable .
We wo n't even go into billing .
For a small four physician group like ours , we could make do I suppose .
For a large hospital in a litigious part of the country ?
I do n't know .
I suppose the answer is updatable RFIDs in every citizen so that medical info can travel with and be available with the patient , right ?
Welcome to the future everyone .</tokentext>
<sentencetext>I do IT for a small multispeciality group.
This story really points out some problems I've seen.
We are in a small town, we have surges, brownouts, you name it.
I occasionally have problems even though all my racks are behind decent APC UPSes/conditioners.
Inevitably though, spring and fall we have storms and people fire up their AC and the power grid is for crap.
I've tried to work with the utility company but they *deny everything*.
At this point I am thinking of getting management involved and pulling together a group of merchants who are IT heavy and petitioning the utility directly or through the state.
I do worry about the repercussions though.
As far as EMR goes, we use redundant systems, offsite backup but with imaging we have well over a TB of data.
If the system were to go completely fubar, I don't know what would happen.
Critical info like allergic reactions, med lists, would be unavailable.
We won't even go into billing.
For a small four physician group like ours, we could make do I suppose.
For a large hospital in a litigious part of the country?
I don't know.
I suppose the answer is updatable RFIDs in every citizen so that medical info can travel with and be available with the patient, right?
Welcome to the future everyone.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28214565</id>
	<title>Re:Nurse != Secretary</title>
	<author>PTFD5023</author>
	<datestamp>1244107920000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>I think this has more to do with Management not being able to properly bill insurance companies. Because profit is more important than human lives.</p></div><p>You would be surprised how often this happens. Before moving into the public service arena, I worked for a hospital-run ambulance service. I often went round and round with management because I didn't obtain complete insurance information (never mind the fact that they could get it out of the computer, and I was too busy taking care of the patient to worry about extra paperwork). </p><p>I ended up resigning when our chart review was based more on insurance billing information and whether we did extra billable procedures rather than the quality of our patient care.</p></div>
	</htmltext>
<tokenext>I think this has more to do with Management not being able to properly bill insurance companies .
Because profit is more important than human lives.You would be surprised how often this happens .
Before moving into the public service arena , I worked for a hospital-run ambulance service .
I often went round and round with management because I did n't obtain complete insurance information ( never mind the fact that they could get it out of the computer , and I was too busy taking care of the patient to worry about extra paperwork ) .
I ended up resigning when our chart review was based more on insurance billing information and whether we did extra billable procedures rather than the quality of our patient care .</tokentext>
<sentencetext>I think this has more to do with Management not being able to properly bill insurance companies.
Because profit is more important than human lives.You would be surprised how often this happens.
Before moving into the public service arena, I worked for a hospital-run ambulance service.
I often went round and round with management because I didn't obtain complete insurance information (never mind the fact that they could get it out of the computer, and I was too busy taking care of the patient to worry about extra paperwork).
I ended up resigning when our chart review was based more on insurance billing information and whether we did extra billable procedures rather than the quality of our patient care.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209753</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210005</id>
	<title>I've been waiting!</title>
	<author>Anonymous</author>
	<datestamp>1244131980000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>My research seems to indicate that Clarian uses Cerner as their EMR, which is disappointing, because I was looking for a reason to finally make this joke:</p><p> <a href="http://www.epicsystems.com/" title="epicsystems.com" rel="nofollow">Epic</a> [epicsystems.com] fail.</p></htmltext>
<tokenext>My research seems to indicate that Clarian uses Cerner as their EMR , which is disappointing , because I was looking for a reason to finally make this joke : Epic [ epicsystems.com ] fail .</tokentext>
<sentencetext>My research seems to indicate that Clarian uses Cerner as their EMR, which is disappointing, because I was looking for a reason to finally make this joke: Epic [epicsystems.com] fail.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28214825</id>
	<title>Re:It's Not Just Any Beaurocracy</title>
	<author>Ironica</author>
	<datestamp>1244109180000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>In some cases that's true, but not usually.  It's only true if they already have records for the patient, and if they have identified the patient, and if they have bothered to look it up.</p></div><p>Whenever I've sought medical care, regardless of whether it was a scheduled visit, urgent care, or hospital admission, the experience usually includes two questions early on:</p><p>"Are you allergic to any medication?"<br>"Are you currently taking any prescription or over-the-counter medication?"</p><p>I get asked these questions even in situations where I know they're staring at my previous answers on the screen in front of them.  They want to see if anything's changed.</p><p>Now... they can, do, and did still ask these questions without the EMR.  The problem becomes where the ANSWERS go.  Someone asks the question, writes the answer down on the paper form they fell back to, and....</p><p>If this was a hospital still using paper for their primary charting, it would get routed into the paper chart.  That chart would be put in a pocket made for it on the exam room door, or would be given to the chart runner to take where it needs to go, etc. There would be PEOPLE whose job it is to get that chart where it's going.</p><p>One of the advantages of an EMR/EHR is that you don't need all these people to file, pull, and run charts around your office/hospital.  It's a cost savings, and an efficiency gain.  But it also means that, when you fall back to paper, you don't have those people you used to to do all that paper-routing.  For an hour or two, this isn't such a horrible problem... but when it goes on, and the paper stacks up, you start to have trouble keeping the pieces of paper in the right place, so that you have access to information that YOUR FACILITY generated just half an hour ago.</p><p>I can totally understand why this happened.  I'm glad they handled it, instead of just ignoring the problem.</p></div>
	</htmltext>
<tokenext>In some cases that 's true , but not usually .
It 's only true if they already have records for the patient , and if they have identified the patient , and if they have bothered to look it up.Whenever I 've sought medical care , regardless of whether it was a scheduled visit , urgent care , or hospital admission , the experience usually includes two questions early on : " Are you allergic to any medication ?
" " Are you currently taking any prescription or over-the-counter medication ?
" I get asked these questions even in situations where I know they 're staring at my previous answers on the screen in front of them .
They want to see if anything 's changed.Now... they can , do , and did still ask these questions without the EMR .
The problem becomes where the ANSWERS go .
Someone asks the question , writes the answer down on the paper form they fell back to , and....If this was a hospital still using paper for their primary charting , it would get routed into the paper chart .
That chart would be put in a pocket made for it on the exam room door , or would be given to the chart runner to take where it needs to go , etc .
There would be PEOPLE whose job it is to get that chart where it 's going.One of the advantages of an EMR/EHR is that you do n't need all these people to file , pull , and run charts around your office/hospital .
It 's a cost savings , and an efficiency gain .
But it also means that , when you fall back to paper , you do n't have those people you used to to do all that paper-routing .
For an hour or two , this is n't such a horrible problem... but when it goes on , and the paper stacks up , you start to have trouble keeping the pieces of paper in the right place , so that you have access to information that YOUR FACILITY generated just half an hour ago.I can totally understand why this happened .
I 'm glad they handled it , instead of just ignoring the problem .</tokentext>
<sentencetext>In some cases that's true, but not usually.
It's only true if they already have records for the patient, and if they have identified the patient, and if they have bothered to look it up.Whenever I've sought medical care, regardless of whether it was a scheduled visit, urgent care, or hospital admission, the experience usually includes two questions early on:"Are you allergic to any medication?
""Are you currently taking any prescription or over-the-counter medication?
"I get asked these questions even in situations where I know they're staring at my previous answers on the screen in front of them.
They want to see if anything's changed.Now... they can, do, and did still ask these questions without the EMR.
The problem becomes where the ANSWERS go.
Someone asks the question, writes the answer down on the paper form they fell back to, and....If this was a hospital still using paper for their primary charting, it would get routed into the paper chart.
That chart would be put in a pocket made for it on the exam room door, or would be given to the chart runner to take where it needs to go, etc.
There would be PEOPLE whose job it is to get that chart where it's going.One of the advantages of an EMR/EHR is that you don't need all these people to file, pull, and run charts around your office/hospital.
It's a cost savings, and an efficiency gain.
But it also means that, when you fall back to paper, you don't have those people you used to to do all that paper-routing.
For an hour or two, this isn't such a horrible problem... but when it goes on, and the paper stacks up, you start to have trouble keeping the pieces of paper in the right place, so that you have access to information that YOUR FACILITY generated just half an hour ago.I can totally understand why this happened.
I'm glad they handled it, instead of just ignoring the problem.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209439</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212247</id>
	<title>Not a big deal</title>
	<author>800DeadCCs</author>
	<datestamp>1244141340000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>It was a 2 hour ambulance bypass.<br>That's nothing.  Seriously.<br>They weren't turning away people at the door, just sending ambulances elsewhere.</p><p>Look at when it happened, 1am.<br>They would have what, one, maybe two if they're lucky, people working at the admit desk at that time.<br>Yeah, it might back up a bit., but it shouldn't.</p><p>This was a failure of hospital policy more than an IT system failure.</p><p>disclaimer: I work at a HIMSS level 6 rated hospital.<br>(I've even had the experience of being an inpatient recently. Knowing the system, I still said "Wow!  This is how things need to be run".)<br>Almost everything is computerized.<br>Everything is backed-up and redundant, and if the whole thing went down, you wouldn't be coming to us because there'd be a huge hole in the ground.</p></htmltext>
<tokenext>It was a 2 hour ambulance bypass.That 's nothing .
Seriously.They were n't turning away people at the door , just sending ambulances elsewhere.Look at when it happened , 1am.They would have what , one , maybe two if they 're lucky , people working at the admit desk at that time.Yeah , it might back up a bit. , but it should n't.This was a failure of hospital policy more than an IT system failure.disclaimer : I work at a HIMSS level 6 rated hospital .
( I 've even had the experience of being an inpatient recently .
Knowing the system , I still said " Wow !
This is how things need to be run " .
) Almost everything is computerized.Everything is backed-up and redundant , and if the whole thing went down , you would n't be coming to us because there 'd be a huge hole in the ground .</tokentext>
<sentencetext>It was a 2 hour ambulance bypass.That's nothing.
Seriously.They weren't turning away people at the door, just sending ambulances elsewhere.Look at when it happened, 1am.They would have what, one, maybe two if they're lucky, people working at the admit desk at that time.Yeah, it might back up a bit., but it shouldn't.This was a failure of hospital policy more than an IT system failure.disclaimer: I work at a HIMSS level 6 rated hospital.
(I've even had the experience of being an inpatient recently.
Knowing the system, I still said "Wow!
This is how things need to be run".
)Almost everything is computerized.Everything is backed-up and redundant, and if the whole thing went down, you wouldn't be coming to us because there'd be a huge hole in the ground.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209547</id>
	<title>This will only get worse.</title>
	<author>Celeste R</author>
	<datestamp>1244129940000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>In a completely computer-oriented hospital system (as more and more hospitals are doing, due to the tax benefits and lack of penalties), it's important that it's up and functional always.</p><p>Take for example:  you don't want to give a patient food that they're allergic to, or medicine that they're allergic to for that matter.  All of that is tracked by computers.</p><p>When there's actual paperwork involved with a computerized medical establishment, it gets very hairy.  A patient may have notified someone of an important condition, only for it to be noted down and slipped into a stack (in this case, a growing stack) of paper.  Such things can lead to lawsuits of malpractice and various other thing, including damaging the reputation of the hospital.</p><p>Furthermore, even when things are going -right-, you don't want paperwork at all in a computerized record system.  Paperwork means that something hasn't been processed yet, and it may be days (or weeks) when that paperwork is found or processed.  In the meantime, people are getting the (wrong) treatment.</p><p>I remember reading a story about a chronic asthma case where only a specific medication worked.  He notified the same clinic 4 times, and the same hospital endlessly, of this, and it nearly led to his death.  He lived because after a week (!) of being in the hospital, someone finally got around to the paperwork, and he was given the appropriate prescription.</p><p>Computerization of the medical establishment sounds like progress, but enforced computerization is -not- a step in the right direction.  Proper computer management (especially in clinics and such) is important, and it's exactly those people who don't know how to make backups and such.</p><p>Washington, if the system works, don't break it, please!</p></htmltext>
<tokenext>In a completely computer-oriented hospital system ( as more and more hospitals are doing , due to the tax benefits and lack of penalties ) , it 's important that it 's up and functional always.Take for example : you do n't want to give a patient food that they 're allergic to , or medicine that they 're allergic to for that matter .
All of that is tracked by computers.When there 's actual paperwork involved with a computerized medical establishment , it gets very hairy .
A patient may have notified someone of an important condition , only for it to be noted down and slipped into a stack ( in this case , a growing stack ) of paper .
Such things can lead to lawsuits of malpractice and various other thing , including damaging the reputation of the hospital.Furthermore , even when things are going -right- , you do n't want paperwork at all in a computerized record system .
Paperwork means that something has n't been processed yet , and it may be days ( or weeks ) when that paperwork is found or processed .
In the meantime , people are getting the ( wrong ) treatment.I remember reading a story about a chronic asthma case where only a specific medication worked .
He notified the same clinic 4 times , and the same hospital endlessly , of this , and it nearly led to his death .
He lived because after a week ( !
) of being in the hospital , someone finally got around to the paperwork , and he was given the appropriate prescription.Computerization of the medical establishment sounds like progress , but enforced computerization is -not- a step in the right direction .
Proper computer management ( especially in clinics and such ) is important , and it 's exactly those people who do n't know how to make backups and such.Washington , if the system works , do n't break it , please !</tokentext>
<sentencetext>In a completely computer-oriented hospital system (as more and more hospitals are doing, due to the tax benefits and lack of penalties), it's important that it's up and functional always.Take for example:  you don't want to give a patient food that they're allergic to, or medicine that they're allergic to for that matter.
All of that is tracked by computers.When there's actual paperwork involved with a computerized medical establishment, it gets very hairy.
A patient may have notified someone of an important condition, only for it to be noted down and slipped into a stack (in this case, a growing stack) of paper.
Such things can lead to lawsuits of malpractice and various other thing, including damaging the reputation of the hospital.Furthermore, even when things are going -right-, you don't want paperwork at all in a computerized record system.
Paperwork means that something hasn't been processed yet, and it may be days (or weeks) when that paperwork is found or processed.
In the meantime, people are getting the (wrong) treatment.I remember reading a story about a chronic asthma case where only a specific medication worked.
He notified the same clinic 4 times, and the same hospital endlessly, of this, and it nearly led to his death.
He lived because after a week (!
) of being in the hospital, someone finally got around to the paperwork, and he was given the appropriate prescription.Computerization of the medical establishment sounds like progress, but enforced computerization is -not- a step in the right direction.
Proper computer management (especially in clinics and such) is important, and it's exactly those people who don't know how to make backups and such.Washington, if the system works, don't break it, please!</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211057</id>
	<title>Diverting patients is nothing unusual</title>
	<author>sjbe</author>
	<datestamp>1244136240000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>But even leaving that aside &#226;" why do problems with paperwork make it necessary to turn away patients?</p> </div><p>Because paperwork is how a hospital communicates.  Without it it is very difficult to effectively treat anything except the simplest problems.  Missing paperwork also prevents billing for services, causes serious legal and standard of care issues, and reduces the number of cases a hospital can effectively manage.</p><p>In any case the hospital did not "turn away" patients, it diverted patients arriving by ambulance to other hospitals.  This is standard practice in every hospital outside of times of crisis.  Sometimes hospitals get more patients than they can handle and so they divert patients to nearby hospitals to handle the overflow.  Happens to smaller Emergency Departments all the time.  Hospitals aren't designed to handle unlimited numbers of cases.  Lack of access to medial records reduces the number of cases a hospital can effectively manage and so diversion becomes the responsible course of action.  They did the right thing.</p><p>One of the reasons electronic records have been slow in coming is that actual paper paperwork has a nearly unbeatable advantage in reliability which is obviously important when lives are on the line.  There are good reasons for electronic medical records but using them always will carry the risk of paralysis when the electrons aren't flowing correctly.  There are manual fallback procedures but they are necessarily less efficient.  Had there been a catastrophe (think terrorist attack or natural disaster) the hospital would have accepted the patients if needed.  Every hospital has contingency plans for circumstances like this.</p><p>In other words, nothing to see here - move along.</p></div>
	</htmltext>
<tokenext>But even leaving that aside   " why do problems with paperwork make it necessary to turn away patients ?
Because paperwork is how a hospital communicates .
Without it it is very difficult to effectively treat anything except the simplest problems .
Missing paperwork also prevents billing for services , causes serious legal and standard of care issues , and reduces the number of cases a hospital can effectively manage.In any case the hospital did not " turn away " patients , it diverted patients arriving by ambulance to other hospitals .
This is standard practice in every hospital outside of times of crisis .
Sometimes hospitals get more patients than they can handle and so they divert patients to nearby hospitals to handle the overflow .
Happens to smaller Emergency Departments all the time .
Hospitals are n't designed to handle unlimited numbers of cases .
Lack of access to medial records reduces the number of cases a hospital can effectively manage and so diversion becomes the responsible course of action .
They did the right thing.One of the reasons electronic records have been slow in coming is that actual paper paperwork has a nearly unbeatable advantage in reliability which is obviously important when lives are on the line .
There are good reasons for electronic medical records but using them always will carry the risk of paralysis when the electrons are n't flowing correctly .
There are manual fallback procedures but they are necessarily less efficient .
Had there been a catastrophe ( think terrorist attack or natural disaster ) the hospital would have accepted the patients if needed .
Every hospital has contingency plans for circumstances like this.In other words , nothing to see here - move along .</tokentext>
<sentencetext>But even leaving that aside â" why do problems with paperwork make it necessary to turn away patients?
Because paperwork is how a hospital communicates.
Without it it is very difficult to effectively treat anything except the simplest problems.
Missing paperwork also prevents billing for services, causes serious legal and standard of care issues, and reduces the number of cases a hospital can effectively manage.In any case the hospital did not "turn away" patients, it diverted patients arriving by ambulance to other hospitals.
This is standard practice in every hospital outside of times of crisis.
Sometimes hospitals get more patients than they can handle and so they divert patients to nearby hospitals to handle the overflow.
Happens to smaller Emergency Departments all the time.
Hospitals aren't designed to handle unlimited numbers of cases.
Lack of access to medial records reduces the number of cases a hospital can effectively manage and so diversion becomes the responsible course of action.
They did the right thing.One of the reasons electronic records have been slow in coming is that actual paper paperwork has a nearly unbeatable advantage in reliability which is obviously important when lives are on the line.
There are good reasons for electronic medical records but using them always will carry the risk of paralysis when the electrons aren't flowing correctly.
There are manual fallback procedures but they are necessarily less efficient.
Had there been a catastrophe (think terrorist attack or natural disaster) the hospital would have accepted the patients if needed.
Every hospital has contingency plans for circumstances like this.In other words, nothing to see here - move along.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209425</id>
	<title>The paperless hospital</title>
	<author>hierofalcon</author>
	<datestamp>1244129520000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>It doesn't surprise me a bit. I know someone who works in a hospital lab. In any large hospital these days the lab equipment automates the reporting of results into "the system". When some part goes down, they can revert to paper for a period of time. At some point, with how short hospitals are running staff, you reach a point that you do not have enough people and free time available to catch back up manually re-entering the data once the failed system comes back up. The time frame varies with the size of the hospital and the patient load.

</p><p>In today's litigious society, it is perfectly reasonable to believe that a major hospital would close to new admissions to get the paperwork caught up rather than risk being sued because the electronic trail was missing. With a health records system not being available to produce histories on patients I could see shutting down even sooner.

</p><p>It's certainly something to be concerned about and it's going to get worse as time goes on. Unfortunately, as the electrical load increases outages are likely to be more frequent as well.</p></htmltext>
<tokenext>It does n't surprise me a bit .
I know someone who works in a hospital lab .
In any large hospital these days the lab equipment automates the reporting of results into " the system " .
When some part goes down , they can revert to paper for a period of time .
At some point , with how short hospitals are running staff , you reach a point that you do not have enough people and free time available to catch back up manually re-entering the data once the failed system comes back up .
The time frame varies with the size of the hospital and the patient load .
In today 's litigious society , it is perfectly reasonable to believe that a major hospital would close to new admissions to get the paperwork caught up rather than risk being sued because the electronic trail was missing .
With a health records system not being available to produce histories on patients I could see shutting down even sooner .
It 's certainly something to be concerned about and it 's going to get worse as time goes on .
Unfortunately , as the electrical load increases outages are likely to be more frequent as well .</tokentext>
<sentencetext>It doesn't surprise me a bit.
I know someone who works in a hospital lab.
In any large hospital these days the lab equipment automates the reporting of results into "the system".
When some part goes down, they can revert to paper for a period of time.
At some point, with how short hospitals are running staff, you reach a point that you do not have enough people and free time available to catch back up manually re-entering the data once the failed system comes back up.
The time frame varies with the size of the hospital and the patient load.
In today's litigious society, it is perfectly reasonable to believe that a major hospital would close to new admissions to get the paperwork caught up rather than risk being sued because the electronic trail was missing.
With a health records system not being available to produce histories on patients I could see shutting down even sooner.
It's certainly something to be concerned about and it's going to get worse as time goes on.
Unfortunately, as the electrical load increases outages are likely to be more frequent as well.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28216921</id>
	<title>Re:Two Word Answer: Patient Safety</title>
	<author>Anonymous</author>
	<datestamp>1244120700000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>I agree with you on public safety. However, a hospital that is not prepared for a emergency such as this, is probably not able to handle health emergencies of a large scale. This is the year 2009. There are things such as back up systems. I am sure a hospital executive got a bonus for saving cost in this area. It's these kind of decisions that has depleted jobs and income of all business.</p></htmltext>
<tokenext>I agree with you on public safety .
However , a hospital that is not prepared for a emergency such as this , is probably not able to handle health emergencies of a large scale .
This is the year 2009 .
There are things such as back up systems .
I am sure a hospital executive got a bonus for saving cost in this area .
It 's these kind of decisions that has depleted jobs and income of all business .</tokentext>
<sentencetext>I agree with you on public safety.
However, a hospital that is not prepared for a emergency such as this, is probably not able to handle health emergencies of a large scale.
This is the year 2009.
There are things such as back up systems.
I am sure a hospital executive got a bonus for saving cost in this area.
It's these kind of decisions that has depleted jobs and income of all business.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209501</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28217881</id>
	<title>Billing</title>
	<author>Anonymous</author>
	<datestamp>1244130480000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Without the computers, they can't keep track of the 15 specialists that need to bill you a full hour for the 3 minute walk-by interviews just to say that they aren't needed.</p></htmltext>
<tokenext>Without the computers , they ca n't keep track of the 15 specialists that need to bill you a full hour for the 3 minute walk-by interviews just to say that they are n't needed .</tokentext>
<sentencetext>Without the computers, they can't keep track of the 15 specialists that need to bill you a full hour for the 3 minute walk-by interviews just to say that they aren't needed.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212435</id>
	<title>Re:Not a huge deal</title>
	<author>bigdavex</author>
	<datestamp>1244142060000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Yeah, absolutely.  Manning could hit Wishard from Methodist with a good throw.</p></htmltext>
<tokenext>Yeah , absolutely .
Manning could hit Wishard from Methodist with a good throw .</tokentext>
<sentencetext>Yeah, absolutely.
Manning could hit Wishard from Methodist with a good throw.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209479</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211555</id>
	<title>Paperwork</title>
	<author>Dunbal</author>
	<datestamp>1244138220000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><i> why do problems with paperwork make it necessary to turn away patients? </i></p><p>
&nbsp; &nbsp; &nbsp; You can thank the legal system, multi-million dollar lawsuit awards, and greedy lawyers and "patients" for that one. As a doctor I am appalled at the amount of paperwork involved - and I don't even practice in the US. The volume paperwork has NOTHING to do with medicine, and EVERYTHING to do with physicians and staff protecting ourselves from potential litigation.</p><p>
&nbsp; &nbsp; &nbsp; It's sad to think that the decision not to treat should take precedence over the patient's comfort, but frankly why should a hospital or staff expose themselves to potential litigation? It's much safer legally to inform the ambulance services that the hospital is no longer accepting patients. This is the world "we" (ie the courts, the lawyers and the patients) have built. And even now you find flaws in their logic, and someone is probably thinking of suing (or trying to sue) the hospital over this. In medicine you are always damned if you do, and damned if you don't.</p><p>
&nbsp; &nbsp; &nbsp; Ideally paperwork would be the bare minimum to inform my colleagues of what my diagnosis is, why, and what my plan is. I can do that in a couple sentences per patient. Everything else is just legalese. Remember that the medical file is, in a way, a method of getting a physician to waive his protections from self-incrimination. There is no "5th" amendment for physicians. If it's not in the file, it doesn't exist or it never happened. And if it's in the file, it had better be 100\% right, all the time.</p></htmltext>
<tokenext>why do problems with paperwork make it necessary to turn away patients ?
      You can thank the legal system , multi-million dollar lawsuit awards , and greedy lawyers and " patients " for that one .
As a doctor I am appalled at the amount of paperwork involved - and I do n't even practice in the US .
The volume paperwork has NOTHING to do with medicine , and EVERYTHING to do with physicians and staff protecting ourselves from potential litigation .
      It 's sad to think that the decision not to treat should take precedence over the patient 's comfort , but frankly why should a hospital or staff expose themselves to potential litigation ?
It 's much safer legally to inform the ambulance services that the hospital is no longer accepting patients .
This is the world " we " ( ie the courts , the lawyers and the patients ) have built .
And even now you find flaws in their logic , and someone is probably thinking of suing ( or trying to sue ) the hospital over this .
In medicine you are always damned if you do , and damned if you do n't .
      Ideally paperwork would be the bare minimum to inform my colleagues of what my diagnosis is , why , and what my plan is .
I can do that in a couple sentences per patient .
Everything else is just legalese .
Remember that the medical file is , in a way , a method of getting a physician to waive his protections from self-incrimination .
There is no " 5th " amendment for physicians .
If it 's not in the file , it does n't exist or it never happened .
And if it 's in the file , it had better be 100 \ % right , all the time .</tokentext>
<sentencetext> why do problems with paperwork make it necessary to turn away patients?
      You can thank the legal system, multi-million dollar lawsuit awards, and greedy lawyers and "patients" for that one.
As a doctor I am appalled at the amount of paperwork involved - and I don't even practice in the US.
The volume paperwork has NOTHING to do with medicine, and EVERYTHING to do with physicians and staff protecting ourselves from potential litigation.
      It's sad to think that the decision not to treat should take precedence over the patient's comfort, but frankly why should a hospital or staff expose themselves to potential litigation?
It's much safer legally to inform the ambulance services that the hospital is no longer accepting patients.
This is the world "we" (ie the courts, the lawyers and the patients) have built.
And even now you find flaws in their logic, and someone is probably thinking of suing (or trying to sue) the hospital over this.
In medicine you are always damned if you do, and damned if you don't.
      Ideally paperwork would be the bare minimum to inform my colleagues of what my diagnosis is, why, and what my plan is.
I can do that in a couple sentences per patient.
Everything else is just legalese.
Remember that the medical file is, in a way, a method of getting a physician to waive his protections from self-incrimination.
There is no "5th" amendment for physicians.
If it's not in the file, it doesn't exist or it never happened.
And if it's in the file, it had better be 100\% right, all the time.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28226481</id>
	<title>Meta</title>
	<author>jra</author>
	<datestamp>1244233380000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Just lately, Slashdot's preview engine has taken to eating the empty lines in paragraph breaks; they do show up in the final posting, though.</p><p>It is annoying, yes.</p></htmltext>
<tokenext>Just lately , Slashdot 's preview engine has taken to eating the empty lines in paragraph breaks ; they do show up in the final posting , though.It is annoying , yes .</tokentext>
<sentencetext>Just lately, Slashdot's preview engine has taken to eating the empty lines in paragraph breaks; they do show up in the final posting, though.It is annoying, yes.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212107</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209677</id>
	<title>Let me see....</title>
	<author>Anonymous</author>
	<datestamp>1244130420000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>2</modscore>
	<htmltext>"Hospital Turns Away Ambulances Computers Go Down"<br> <br>

I guess they meant "The computers in the Away Ambulances for Turns Hospital stopped working".<br> <br>Or maybe, "The Computers went down when the Hospital started Turning Ambulances Away." - some sort of sympathy strike action, I suppose; or maybe the hospital uses some computer repair technicians that call themselves PC medics, or PC Doctors and they ride around in "ambulances" that are full of tools and replacement parts.  They arrived to do some maintenance and someone turned them away, resulting in the computers crashing.<br> <br>
Or perhaps the article title needs some clarifying punctuation.</htmltext>
<tokenext>" Hospital Turns Away Ambulances Computers Go Down " I guess they meant " The computers in the Away Ambulances for Turns Hospital stopped working " .
Or maybe , " The Computers went down when the Hospital started Turning Ambulances Away .
" - some sort of sympathy strike action , I suppose ; or maybe the hospital uses some computer repair technicians that call themselves PC medics , or PC Doctors and they ride around in " ambulances " that are full of tools and replacement parts .
They arrived to do some maintenance and someone turned them away , resulting in the computers crashing .
Or perhaps the article title needs some clarifying punctuation .</tokentext>
<sentencetext>"Hospital Turns Away Ambulances Computers Go Down" 

I guess they meant "The computers in the Away Ambulances for Turns Hospital stopped working".
Or maybe, "The Computers went down when the Hospital started Turning Ambulances Away.
" - some sort of sympathy strike action, I suppose; or maybe the hospital uses some computer repair technicians that call themselves PC medics, or PC Doctors and they ride around in "ambulances" that are full of tools and replacement parts.
They arrived to do some maintenance and someone turned them away, resulting in the computers crashing.
Or perhaps the article title needs some clarifying punctuation.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28218663</id>
	<title>LAME EXCUSE!!! (i have proof!)</title>
	<author>stuffeh</author>
	<datestamp>1244138640000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>My mother is a medical records coder.  She needed to pass an exam to get a certificate as a "Registered Health Information Technicians" to able to input the data into the computer from the ER paperwork.  What she does is she sits at the computer, reading over the ER paper work, and inputting it into the computer.  This information is how the government gets the statistics on how people injure themselves as well.  There has been numerous times when the paper work has piled up so that she is quite literally forced into doing overtime and even going in on SATURDAYS to be able to catch up.<br> <br>

So in my humble opinion, it sounds like the hospital just doesn't want to give their medical records techs overtime to catch up on the paperwork that they miss due to the computer systems being down.  But I could be wrong.  Yes, I am aware it says "access records of patients" but when visiting the ER, they really only just input records and not retrieve them much + if it is recent enough, can always go get the hard copies, they should have hard copies just for the reason the system goes down.  The more I think about it, the more I am convinced that the hospital isn't able/doesn't want to pay for overtime to catch up on the work.<br> <br>

Disclaimer: this is for the state California, might not be be so with Indianapolis, and they just skip having medical records coders, and the nurses fill in the reports directly to the mainframe.  But still, nothing one or two people won't be able to clear up with a Saturday of overtime.</htmltext>
<tokenext>My mother is a medical records coder .
She needed to pass an exam to get a certificate as a " Registered Health Information Technicians " to able to input the data into the computer from the ER paperwork .
What she does is she sits at the computer , reading over the ER paper work , and inputting it into the computer .
This information is how the government gets the statistics on how people injure themselves as well .
There has been numerous times when the paper work has piled up so that she is quite literally forced into doing overtime and even going in on SATURDAYS to be able to catch up .
So in my humble opinion , it sounds like the hospital just does n't want to give their medical records techs overtime to catch up on the paperwork that they miss due to the computer systems being down .
But I could be wrong .
Yes , I am aware it says " access records of patients " but when visiting the ER , they really only just input records and not retrieve them much + if it is recent enough , can always go get the hard copies , they should have hard copies just for the reason the system goes down .
The more I think about it , the more I am convinced that the hospital is n't able/does n't want to pay for overtime to catch up on the work .
Disclaimer : this is for the state California , might not be be so with Indianapolis , and they just skip having medical records coders , and the nurses fill in the reports directly to the mainframe .
But still , nothing one or two people wo n't be able to clear up with a Saturday of overtime .</tokentext>
<sentencetext>My mother is a medical records coder.
She needed to pass an exam to get a certificate as a "Registered Health Information Technicians" to able to input the data into the computer from the ER paperwork.
What she does is she sits at the computer, reading over the ER paper work, and inputting it into the computer.
This information is how the government gets the statistics on how people injure themselves as well.
There has been numerous times when the paper work has piled up so that she is quite literally forced into doing overtime and even going in on SATURDAYS to be able to catch up.
So in my humble opinion, it sounds like the hospital just doesn't want to give their medical records techs overtime to catch up on the paperwork that they miss due to the computer systems being down.
But I could be wrong.
Yes, I am aware it says "access records of patients" but when visiting the ER, they really only just input records and not retrieve them much + if it is recent enough, can always go get the hard copies, they should have hard copies just for the reason the system goes down.
The more I think about it, the more I am convinced that the hospital isn't able/doesn't want to pay for overtime to catch up on the work.
Disclaimer: this is for the state California, might not be be so with Indianapolis, and they just skip having medical records coders, and the nurses fill in the reports directly to the mainframe.
But still, nothing one or two people won't be able to clear up with a Saturday of overtime.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209453</id>
	<title>the real reason</title>
	<author>Jeff1946</author>
	<datestamp>1244129580000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>They were afraid that without their data system they wouldn't be able to bill for the services to the patients.</htmltext>
<tokenext>They were afraid that without their data system they would n't be able to bill for the services to the patients .</tokentext>
<sentencetext>They were afraid that without their data system they wouldn't be able to bill for the services to the patients.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209467</id>
	<title>Re:A one word answer</title>
	<author>lorenlal</author>
	<datestamp>1244129640000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>4</modscore>
	<htmltext>Funny aside.  I happen to know a few physicians pretty well outside their professions. I heard a lovely story involving a surgeon in an office that didn't use paper records.  Everything was done through an EMR system.<br><br>The "computers were down" as the story was relayed.  The surgeon called the family physician asking him about the medical history of the patient.  The family doc (primary) asked what was wrong.  The surgeon replied that the patient was in the waiting room, but since the EMR system was down, he didn't know anything about the patient.  The primary responded with, "By any chance... Did you ask them?" to which the surgeon responded, "What?"  The surgeon had a perfectly compus mentus patient, and didn't even bother to ask them a question because the EMR system was down.<br><br>Sometimes the lawyers don't even have to be involved for epic failure.</htmltext>
<tokenext>Funny aside .
I happen to know a few physicians pretty well outside their professions .
I heard a lovely story involving a surgeon in an office that did n't use paper records .
Everything was done through an EMR system.The " computers were down " as the story was relayed .
The surgeon called the family physician asking him about the medical history of the patient .
The family doc ( primary ) asked what was wrong .
The surgeon replied that the patient was in the waiting room , but since the EMR system was down , he did n't know anything about the patient .
The primary responded with , " By any chance... Did you ask them ?
" to which the surgeon responded , " What ?
" The surgeon had a perfectly compus mentus patient , and did n't even bother to ask them a question because the EMR system was down.Sometimes the lawyers do n't even have to be involved for epic failure .</tokentext>
<sentencetext>Funny aside.
I happen to know a few physicians pretty well outside their professions.
I heard a lovely story involving a surgeon in an office that didn't use paper records.
Everything was done through an EMR system.The "computers were down" as the story was relayed.
The surgeon called the family physician asking him about the medical history of the patient.
The family doc (primary) asked what was wrong.
The surgeon replied that the patient was in the waiting room, but since the EMR system was down, he didn't know anything about the patient.
The primary responded with, "By any chance... Did you ask them?
" to which the surgeon responded, "What?
"  The surgeon had a perfectly compus mentus patient, and didn't even bother to ask them a question because the EMR system was down.Sometimes the lawyers don't even have to be involved for epic failure.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28215655</id>
	<title>Re:In need of a form cycle system</title>
	<author>Ironica</author>
	<datestamp>1244113320000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>They probably have a form cycle system.  That's probably what they implemented when the system went down and they had to "drop to paper."</p><p>Being able to scan the forms in is useful for looking up later what happened during the outage, but it's of no use WHILE the system is down.  Your form cycle system may rely on temp workers to come in and scan all those forms after an outage.  The system in TFA had been down more than 24 hours when they went on diversion; by that time, the amount of papers waiting to be scanned was probably staggering.</p></htmltext>
<tokenext>They probably have a form cycle system .
That 's probably what they implemented when the system went down and they had to " drop to paper .
" Being able to scan the forms in is useful for looking up later what happened during the outage , but it 's of no use WHILE the system is down .
Your form cycle system may rely on temp workers to come in and scan all those forms after an outage .
The system in TFA had been down more than 24 hours when they went on diversion ; by that time , the amount of papers waiting to be scanned was probably staggering .</tokentext>
<sentencetext>They probably have a form cycle system.
That's probably what they implemented when the system went down and they had to "drop to paper.
"Being able to scan the forms in is useful for looking up later what happened during the outage, but it's of no use WHILE the system is down.
Your form cycle system may rely on temp workers to come in and scan all those forms after an outage.
The system in TFA had been down more than 24 hours when they went on diversion; by that time, the amount of papers waiting to be scanned was probably staggering.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209367</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210411</id>
	<title>Paperwork</title>
	<author>DragonWriter</author>
	<datestamp>1244133660000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>2</modscore>
	<htmltext><blockquote><div><p>But even leaving that aside -- why do problems with paperwork make it necessary to turn away patients?</p></div></blockquote><p>Because orders for (and, where applicable, results from) lab tests, diagnostic imaging, medications, etc. are all "paperwork", and all rather essential parts of patient care, and are particularly time sensitive in the case of emergency care. If you can't process "paperwork" (with or without paper) accurately and timely, you can't properly treat patients.</p><p>Which is why an EHR system shouldn't be purchased without reliability (uptime, etc.) guarantees.</p></div>
	</htmltext>
<tokenext>But even leaving that aside -- why do problems with paperwork make it necessary to turn away patients ? Because orders for ( and , where applicable , results from ) lab tests , diagnostic imaging , medications , etc .
are all " paperwork " , and all rather essential parts of patient care , and are particularly time sensitive in the case of emergency care .
If you ca n't process " paperwork " ( with or without paper ) accurately and timely , you ca n't properly treat patients.Which is why an EHR system should n't be purchased without reliability ( uptime , etc .
) guarantees .</tokentext>
<sentencetext>But even leaving that aside -- why do problems with paperwork make it necessary to turn away patients?Because orders for (and, where applicable, results from) lab tests, diagnostic imaging, medications, etc.
are all "paperwork", and all rather essential parts of patient care, and are particularly time sensitive in the case of emergency care.
If you can't process "paperwork" (with or without paper) accurately and timely, you can't properly treat patients.Which is why an EHR system shouldn't be purchased without reliability (uptime, etc.
) guarantees.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209443</id>
	<title>David Carradine Has Died, He Was Delicious</title>
	<author>Anonymous</author>
	<datestamp>1244129580000</datestamp>
	<modclass>Offtopic</modclass>
	<modscore>-1</modscore>
	<htmltext><p>Words cannot describe how sad this is. Carradine's acting was top-notch for the hey-day of 60's Kung-fu pop culture. His purple colour (a colour option picked up from an earlier version) clashes with the grey of any other window, that can be changed though. The black style of his acting in Kill Bill (Vol. 1 &amp; 2) is overbearing and doesn't meld with his earlier works. His *cough* apparent suicide *cough* stands out like a sore thumb. I somehow feel like his death resembles the chrome looks like a web page, rather than someone who won an award in 2005 for lifetime acting achievements and for browsing web pages. I cannot believe someone who created the Firefox icon could create something so hideous and inappropriate, especially when David Carradine's market share is bad enough already. I could not bear to look at this all day, every day, it would drive me mad.</p><p>A suicidal has-been Kung-fu actor should be transparent, a thin veneer between me and the web page. Not a clown honking his horn in my face. I went into preferences and changed to the Mac "native" theme and no particular colour, mildly improved, but still the black is overpowering, the new-tab button is the wrong colour, and the side pane has a tinge of blue that doesnt work well with the OS X grey. The tab touching the title bar also just looks poor and conflicting. <b>This is the same bullshit I had to put up with when Dana Plato finally offed herself.</b> It's goudy, non-native, clashes with the websites you view, and generally gets in the way, the toolkit underneath still rears it's ugly head in how the app works, and the general layout of the widgets. Apparently Carradine was eaten by wolves on the Connecticut turn-pike. All reports say he was delicious. The dialogues throughout the app crap all over the spacing guides in the HIG. Every inch of this app is annoying and grates on me. I'm not an interface elitist or an apple fanboy, but I can't use software that gets on my nerves and Opera and Vista occupy the top two slots for that. The browser is eclectic, with too many preferences, too complicated preferences, too many customisation options. Features not everybody needs, or wants.</p></htmltext>
<tokenext>Words can not describe how sad this is .
Carradine 's acting was top-notch for the hey-day of 60 's Kung-fu pop culture .
His purple colour ( a colour option picked up from an earlier version ) clashes with the grey of any other window , that can be changed though .
The black style of his acting in Kill Bill ( Vol .
1 &amp; 2 ) is overbearing and does n't meld with his earlier works .
His * cough * apparent suicide * cough * stands out like a sore thumb .
I somehow feel like his death resembles the chrome looks like a web page , rather than someone who won an award in 2005 for lifetime acting achievements and for browsing web pages .
I can not believe someone who created the Firefox icon could create something so hideous and inappropriate , especially when David Carradine 's market share is bad enough already .
I could not bear to look at this all day , every day , it would drive me mad.A suicidal has-been Kung-fu actor should be transparent , a thin veneer between me and the web page .
Not a clown honking his horn in my face .
I went into preferences and changed to the Mac " native " theme and no particular colour , mildly improved , but still the black is overpowering , the new-tab button is the wrong colour , and the side pane has a tinge of blue that doesnt work well with the OS X grey .
The tab touching the title bar also just looks poor and conflicting .
This is the same bullshit I had to put up with when Dana Plato finally offed herself .
It 's goudy , non-native , clashes with the websites you view , and generally gets in the way , the toolkit underneath still rears it 's ugly head in how the app works , and the general layout of the widgets .
Apparently Carradine was eaten by wolves on the Connecticut turn-pike .
All reports say he was delicious .
The dialogues throughout the app crap all over the spacing guides in the HIG .
Every inch of this app is annoying and grates on me .
I 'm not an interface elitist or an apple fanboy , but I ca n't use software that gets on my nerves and Opera and Vista occupy the top two slots for that .
The browser is eclectic , with too many preferences , too complicated preferences , too many customisation options .
Features not everybody needs , or wants .</tokentext>
<sentencetext>Words cannot describe how sad this is.
Carradine's acting was top-notch for the hey-day of 60's Kung-fu pop culture.
His purple colour (a colour option picked up from an earlier version) clashes with the grey of any other window, that can be changed though.
The black style of his acting in Kill Bill (Vol.
1 &amp; 2) is overbearing and doesn't meld with his earlier works.
His *cough* apparent suicide *cough* stands out like a sore thumb.
I somehow feel like his death resembles the chrome looks like a web page, rather than someone who won an award in 2005 for lifetime acting achievements and for browsing web pages.
I cannot believe someone who created the Firefox icon could create something so hideous and inappropriate, especially when David Carradine's market share is bad enough already.
I could not bear to look at this all day, every day, it would drive me mad.A suicidal has-been Kung-fu actor should be transparent, a thin veneer between me and the web page.
Not a clown honking his horn in my face.
I went into preferences and changed to the Mac "native" theme and no particular colour, mildly improved, but still the black is overpowering, the new-tab button is the wrong colour, and the side pane has a tinge of blue that doesnt work well with the OS X grey.
The tab touching the title bar also just looks poor and conflicting.
This is the same bullshit I had to put up with when Dana Plato finally offed herself.
It's goudy, non-native, clashes with the websites you view, and generally gets in the way, the toolkit underneath still rears it's ugly head in how the app works, and the general layout of the widgets.
Apparently Carradine was eaten by wolves on the Connecticut turn-pike.
All reports say he was delicious.
The dialogues throughout the app crap all over the spacing guides in the HIG.
Every inch of this app is annoying and grates on me.
I'm not an interface elitist or an apple fanboy, but I can't use software that gets on my nerves and Opera and Vista occupy the top two slots for that.
The browser is eclectic, with too many preferences, too complicated preferences, too many customisation options.
Features not everybody needs, or wants.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28218725</id>
	<title>Re:Paperwork</title>
	<author>stuffeh</author>
	<datestamp>1244139480000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>You're kidding right? NO hospital is completely computerized.  They ALL have paper work and patient files.  My mother is a medical records coder and needed to take a certification test before she would even be considered as a candidate for the position in California.  It isn't mandatory, but most hospitals prefer it.  Anyways, several times the paper would would build up for one reason (coworkers on vacation) or another (computer system down) and when it does her boss would force her to take OT (time and a half) to finish the work, even if that means working over the weekends.<br> <br>

If you walk into any hospital, I would guarantee that doctors are walking around with pen and paper and not tablets or palm pilots.  Sure there would be digital x-rays and blood sampling and easily ties in with the bar code on your admission bracelet, but they can always burn the data onto cds whenever and look at on any terminal if the network is down.  If not, then someone screwed up big time.<br> <br>

TLDR: Paperwork is everywhere in the hospital, it seems like the hospital doesn't want to make people take OT to catchup on the "mountain" of work.</htmltext>
<tokenext>You 're kidding right ?
NO hospital is completely computerized .
They ALL have paper work and patient files .
My mother is a medical records coder and needed to take a certification test before she would even be considered as a candidate for the position in California .
It is n't mandatory , but most hospitals prefer it .
Anyways , several times the paper would would build up for one reason ( coworkers on vacation ) or another ( computer system down ) and when it does her boss would force her to take OT ( time and a half ) to finish the work , even if that means working over the weekends .
If you walk into any hospital , I would guarantee that doctors are walking around with pen and paper and not tablets or palm pilots .
Sure there would be digital x-rays and blood sampling and easily ties in with the bar code on your admission bracelet , but they can always burn the data onto cds whenever and look at on any terminal if the network is down .
If not , then someone screwed up big time .
TLDR : Paperwork is everywhere in the hospital , it seems like the hospital does n't want to make people take OT to catchup on the " mountain " of work .</tokentext>
<sentencetext>You're kidding right?
NO hospital is completely computerized.
They ALL have paper work and patient files.
My mother is a medical records coder and needed to take a certification test before she would even be considered as a candidate for the position in California.
It isn't mandatory, but most hospitals prefer it.
Anyways, several times the paper would would build up for one reason (coworkers on vacation) or another (computer system down) and when it does her boss would force her to take OT (time and a half) to finish the work, even if that means working over the weekends.
If you walk into any hospital, I would guarantee that doctors are walking around with pen and paper and not tablets or palm pilots.
Sure there would be digital x-rays and blood sampling and easily ties in with the bar code on your admission bracelet, but they can always burn the data onto cds whenever and look at on any terminal if the network is down.
If not, then someone screwed up big time.
TLDR: Paperwork is everywhere in the hospital, it seems like the hospital doesn't want to make people take OT to catchup on the "mountain" of work.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210411</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211299</id>
	<title>Other hospitals? Sort of.</title>
	<author>superdana</author>
	<datestamp>1244137200000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><i>there obviously were other, more smoothly running hospitals to send the patient to</i> <br>
<br>
Yes, though all of those other hospitals are run by Clarian, the same company that manages Methodist. God help us if we ever have a more centralized problem.</htmltext>
<tokenext>there obviously were other , more smoothly running hospitals to send the patient to Yes , though all of those other hospitals are run by Clarian , the same company that manages Methodist .
God help us if we ever have a more centralized problem .</tokentext>
<sentencetext>there obviously were other, more smoothly running hospitals to send the patient to 

Yes, though all of those other hospitals are run by Clarian, the same company that manages Methodist.
God help us if we ever have a more centralized problem.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209791</id>
	<title>So what if the headline is worded funny</title>
	<author>davmoo</author>
	<datestamp>1244130960000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>3</modscore>
	<htmltext><p>It doesn't matter that the headline is worded funny, because the majority of you responding so far obviously did not RTFA.  But then why should I be surprised, this being Slashdot and all.</p><p>If you had read the article, you would know that the hospital only requested that ambulances *in route to the hospital* reroute to other area hospitals (and Indianapolis has no shortage of hospitals).  Patients who were already there were not turned away, and patients who showed up using methods other than ambulances were not turned away.</p></htmltext>
<tokenext>It does n't matter that the headline is worded funny , because the majority of you responding so far obviously did not RTFA .
But then why should I be surprised , this being Slashdot and all.If you had read the article , you would know that the hospital only requested that ambulances * in route to the hospital * reroute to other area hospitals ( and Indianapolis has no shortage of hospitals ) .
Patients who were already there were not turned away , and patients who showed up using methods other than ambulances were not turned away .</tokentext>
<sentencetext>It doesn't matter that the headline is worded funny, because the majority of you responding so far obviously did not RTFA.
But then why should I be surprised, this being Slashdot and all.If you had read the article, you would know that the hospital only requested that ambulances *in route to the hospital* reroute to other area hospitals (and Indianapolis has no shortage of hospitals).
Patients who were already there were not turned away, and patients who showed up using methods other than ambulances were not turned away.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209927</id>
	<title>Re:A one word answer</title>
	<author>rakkasan</author>
	<datestamp>1244131560000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Liability, yep..give a patient a contra indicated med..and the hospital will get sued big time.  Which is more likely without the afore mentioned records.</p></htmltext>
<tokenext>Liability , yep..give a patient a contra indicated med..and the hospital will get sued big time .
Which is more likely without the afore mentioned records .</tokentext>
<sentencetext>Liability, yep..give a patient a contra indicated med..and the hospital will get sued big time.
Which is more likely without the afore mentioned records.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209545</id>
	<title>Re:A one word answer</title>
	<author>DerekLyons</author>
	<datestamp>1244129940000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Not just lawyers - doctors.</p><p>Without paperwork, they don't know who is in the ER, who is being treated for what, who is allergic to what, who is waiting on what treatment, etc... etc...</p><p>There's a lot of data flowing around an ER, and the quality of the data (is the paperwork up to date) may mean the difference between life and death.</p></htmltext>
<tokenext>Not just lawyers - doctors.Without paperwork , they do n't know who is in the ER , who is being treated for what , who is allergic to what , who is waiting on what treatment , etc... etc...There 's a lot of data flowing around an ER , and the quality of the data ( is the paperwork up to date ) may mean the difference between life and death .</tokentext>
<sentencetext>Not just lawyers - doctors.Without paperwork, they don't know who is in the ER, who is being treated for what, who is allergic to what, who is waiting on what treatment, etc... etc...There's a lot of data flowing around an ER, and the quality of the data (is the paperwork up to date) may mean the difference between life and death.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209591</id>
	<title>Re:A one word answer</title>
	<author>MollyB</author>
	<datestamp>1244130120000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>2</modscore>
	<htmltext><p>I think castigating an entire group of professionals is short-sighted. Perhaps if ours was a less-litigious society, lawyers wouldn't be so powerful. After all, many patients employ lawyers in frivolous lawsuits against hospitals (not all, of course) which may make such detailed health records necessary (even to <i>begin</i> services). Lawyers are just functionaries. Blaming them is like blaming the hammer for hitting your thumb instead of the nail.</p><p>I agree with the sentiment above that we place too much faith in our sprawling infrastructure rather than designing proper failover systems in every new project.</p></htmltext>
<tokenext>I think castigating an entire group of professionals is short-sighted .
Perhaps if ours was a less-litigious society , lawyers would n't be so powerful .
After all , many patients employ lawyers in frivolous lawsuits against hospitals ( not all , of course ) which may make such detailed health records necessary ( even to begin services ) .
Lawyers are just functionaries .
Blaming them is like blaming the hammer for hitting your thumb instead of the nail.I agree with the sentiment above that we place too much faith in our sprawling infrastructure rather than designing proper failover systems in every new project .</tokentext>
<sentencetext>I think castigating an entire group of professionals is short-sighted.
Perhaps if ours was a less-litigious society, lawyers wouldn't be so powerful.
After all, many patients employ lawyers in frivolous lawsuits against hospitals (not all, of course) which may make such detailed health records necessary (even to begin services).
Lawyers are just functionaries.
Blaming them is like blaming the hammer for hitting your thumb instead of the nail.I agree with the sentiment above that we place too much faith in our sprawling infrastructure rather than designing proper failover systems in every new project.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209267</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210851</id>
	<title>High Availability</title>
	<author>lymond01</author>
	<datestamp>1244135340000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>I just like to note here that I started in the early 90s with a company that didn't care to invest too much in infrastructure.  Now I'm working at a University and they care about their data, but also don't want to spend money on keeping it safe.  This makes my job easier, but I don't sleep as well at night knowing that I don't have the best backup scheme or the best surge protection, simply because I can't afford it.  Not having the experience of keeping truly critical data safe, my heart palpitates thinking about working in IT for a hospital where not just your job but people's lives are on the line if you screw up.</p><p>I stress enough about kicking Eudora to the curb, never mind trying to make 100s of TB of data highly available in case a doctor needs a patients allergy history pulled in a blink or we're all dead, Scotty.</p></htmltext>
<tokenext>I just like to note here that I started in the early 90s with a company that did n't care to invest too much in infrastructure .
Now I 'm working at a University and they care about their data , but also do n't want to spend money on keeping it safe .
This makes my job easier , but I do n't sleep as well at night knowing that I do n't have the best backup scheme or the best surge protection , simply because I ca n't afford it .
Not having the experience of keeping truly critical data safe , my heart palpitates thinking about working in IT for a hospital where not just your job but people 's lives are on the line if you screw up.I stress enough about kicking Eudora to the curb , never mind trying to make 100s of TB of data highly available in case a doctor needs a patients allergy history pulled in a blink or we 're all dead , Scotty .</tokentext>
<sentencetext>I just like to note here that I started in the early 90s with a company that didn't care to invest too much in infrastructure.
Now I'm working at a University and they care about their data, but also don't want to spend money on keeping it safe.
This makes my job easier, but I don't sleep as well at night knowing that I don't have the best backup scheme or the best surge protection, simply because I can't afford it.
Not having the experience of keeping truly critical data safe, my heart palpitates thinking about working in IT for a hospital where not just your job but people's lives are on the line if you screw up.I stress enough about kicking Eudora to the curb, never mind trying to make 100s of TB of data highly available in case a doctor needs a patients allergy history pulled in a blink or we're all dead, Scotty.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210295</id>
	<title>This is incredibly common</title>
	<author>Judinous</author>
	<datestamp>1244133180000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>2</modscore>
	<htmltext>From what my EMT friends have told me, many hospitals are nearly permanently on "divert" status.  Whenever a hospital is nearly full of patients (and many, particularly in large cities, almost always are) or their ability to accept and treat people is negatively impacted in some way (such as in this case), they go into divert status.  This doesn't mean that they turn away people who come in for treatment, as anyone who comes in the door is still accepted.  All it means that when an EMT picks up a patient and they see that one hospital is 12 minutes away, while another is 10 minutes away but on divert status, they may choose to go to the first hospital.  If the patient is in critical condition and every minute matters, however, they will still go to the second for treatment.  It's a logical measure that helps to ensure that everyone is treated in the most efficient manner.</htmltext>
<tokenext>From what my EMT friends have told me , many hospitals are nearly permanently on " divert " status .
Whenever a hospital is nearly full of patients ( and many , particularly in large cities , almost always are ) or their ability to accept and treat people is negatively impacted in some way ( such as in this case ) , they go into divert status .
This does n't mean that they turn away people who come in for treatment , as anyone who comes in the door is still accepted .
All it means that when an EMT picks up a patient and they see that one hospital is 12 minutes away , while another is 10 minutes away but on divert status , they may choose to go to the first hospital .
If the patient is in critical condition and every minute matters , however , they will still go to the second for treatment .
It 's a logical measure that helps to ensure that everyone is treated in the most efficient manner .</tokentext>
<sentencetext>From what my EMT friends have told me, many hospitals are nearly permanently on "divert" status.
Whenever a hospital is nearly full of patients (and many, particularly in large cities, almost always are) or their ability to accept and treat people is negatively impacted in some way (such as in this case), they go into divert status.
This doesn't mean that they turn away people who come in for treatment, as anyone who comes in the door is still accepted.
All it means that when an EMT picks up a patient and they see that one hospital is 12 minutes away, while another is 10 minutes away but on divert status, they may choose to go to the first hospital.
If the patient is in critical condition and every minute matters, however, they will still go to the second for treatment.
It's a logical measure that helps to ensure that everyone is treated in the most efficient manner.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210313</id>
	<title>Two hospitals affected</title>
	<author>benjamindees</author>
	<datestamp>1244133240000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>The article says that two hospitals were unable to access patient records.  Who knows what the "power surge" actually affected, but it's clear it happened at a shared datacenter.</p><p>Their paperwork increased because they couldn't access the applications hosted by the shared datacenter, which is probably some type of <a href="http://www.microsoft.com/korea/virtualization/casestudy-clarian.mspx" title="microsoft.com" rel="nofollow">retarded Windows Terminal Service</a> [microsoft.com] setup, and they also couldn't just run the applications locally.  So they would have had to start recording data twice, once on paper and another time on their (remote) records system.  After a while, staff would not be able to keep up with the data entry and start diverting people.</p><p>And basically this would not have happened if anyone even slightly competent had designed their electronic records system not to be dependent on a real-time data link to remote application servers.</p></htmltext>
<tokenext>The article says that two hospitals were unable to access patient records .
Who knows what the " power surge " actually affected , but it 's clear it happened at a shared datacenter.Their paperwork increased because they could n't access the applications hosted by the shared datacenter , which is probably some type of retarded Windows Terminal Service [ microsoft.com ] setup , and they also could n't just run the applications locally .
So they would have had to start recording data twice , once on paper and another time on their ( remote ) records system .
After a while , staff would not be able to keep up with the data entry and start diverting people.And basically this would not have happened if anyone even slightly competent had designed their electronic records system not to be dependent on a real-time data link to remote application servers .</tokentext>
<sentencetext>The article says that two hospitals were unable to access patient records.
Who knows what the "power surge" actually affected, but it's clear it happened at a shared datacenter.Their paperwork increased because they couldn't access the applications hosted by the shared datacenter, which is probably some type of retarded Windows Terminal Service [microsoft.com] setup, and they also couldn't just run the applications locally.
So they would have had to start recording data twice, once on paper and another time on their (remote) records system.
After a while, staff would not be able to keep up with the data entry and start diverting people.And basically this would not have happened if anyone even slightly competent had designed their electronic records system not to be dependent on a real-time data link to remote application servers.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28217049</id>
	<title>Re:Two Word Answer: Patient Safety</title>
	<author>AK Marc</author>
	<datestamp>1244121840000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><i>If someone just arrived in the ambulance and is obviously in bad shape, you may not have time to wait for those records or digest their import. But it seems now that making a good educated guess with a high probability of saving a life takes a back seat to being sure of avoiding all possible mistakes.</i> <br> <br>I read TFA, and I think it's wrong.  Hospitals divert ambulances before they get to the door.  They do not just sit silent, wait for them to show up at the door, then say "haha, you have to take them somewhere else."  There are radios and such, and there is communication that would take place.  They may have been placed "on diversion," as that sounds like code for pretending they aren't there, but that's not the same as having people with needs show up and turn them away.</htmltext>
<tokenext>If someone just arrived in the ambulance and is obviously in bad shape , you may not have time to wait for those records or digest their import .
But it seems now that making a good educated guess with a high probability of saving a life takes a back seat to being sure of avoiding all possible mistakes .
I read TFA , and I think it 's wrong .
Hospitals divert ambulances before they get to the door .
They do not just sit silent , wait for them to show up at the door , then say " haha , you have to take them somewhere else .
" There are radios and such , and there is communication that would take place .
They may have been placed " on diversion , " as that sounds like code for pretending they are n't there , but that 's not the same as having people with needs show up and turn them away .</tokentext>
<sentencetext>If someone just arrived in the ambulance and is obviously in bad shape, you may not have time to wait for those records or digest their import.
But it seems now that making a good educated guess with a high probability of saving a life takes a back seat to being sure of avoiding all possible mistakes.
I read TFA, and I think it's wrong.
Hospitals divert ambulances before they get to the door.
They do not just sit silent, wait for them to show up at the door, then say "haha, you have to take them somewhere else.
"  There are radios and such, and there is communication that would take place.
They may have been placed "on diversion," as that sounds like code for pretending they aren't there, but that's not the same as having people with needs show up and turn them away.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28211167</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212943</id>
	<title>I hate to break it you, so suddenly</title>
	<author>SlashDev</author>
	<datestamp>1244144160000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>"But even leaving that aside -- why do problems with paperwork make it necessary to turn away patients?"

Hospitals are in the business of making money, until we have universal health care.</htmltext>
<tokenext>" But even leaving that aside -- why do problems with paperwork make it necessary to turn away patients ?
" Hospitals are in the business of making money , until we have universal health care .</tokentext>
<sentencetext>"But even leaving that aside -- why do problems with paperwork make it necessary to turn away patients?
"

Hospitals are in the business of making money, until we have universal health care.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28229273</id>
	<title>Re:It's here!</title>
	<author>Anonymous</author>
	<datestamp>1244210760000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>Computers that perform fellatio? YES!</p><p>Imagine a beowulf cluster of those...</p></div><p>That's quite a team park you got there. Just imagine the sounds..</p></div>
	</htmltext>
<tokenext>Computers that perform fellatio ?
YES ! Imagine a beowulf cluster of those...That 's quite a team park you got there .
Just imagine the sounds. .</tokentext>
<sentencetext>Computers that perform fellatio?
YES!Imagine a beowulf cluster of those...That's quite a team park you got there.
Just imagine the sounds..
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209553</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210737</id>
	<title>Re:Not a huge deal</title>
	<author>sharkey</author>
	<datestamp>1244134920000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>To be fair to the submitter, the Star was up to its usual standards of vague sensationalism.  While the article mentions the phrase "on diversion", the unknown author of the piece explicitly states that Methodist was turning away "ambulances that came to its doors".</htmltext>
<tokenext>To be fair to the submitter , the Star was up to its usual standards of vague sensationalism .
While the article mentions the phrase " on diversion " , the unknown author of the piece explicitly states that Methodist was turning away " ambulances that came to its doors " .</tokentext>
<sentencetext>To be fair to the submitter, the Star was up to its usual standards of vague sensationalism.
While the article mentions the phrase "on diversion", the unknown author of the piece explicitly states that Methodist was turning away "ambulances that came to its doors".</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209479</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28212533</id>
	<title>its legal and its smart</title>
	<author>benicillin</author>
	<datestamp>1244142540000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>legally they cant take patients in if they cant do an adequate job treating them. i wouldnt be surprised if some of their regular staff was busy fixing the medical records. therefore they were probably short on workers and also unable to keep adequate medical records for patients. this is a big no-no in the health care industry.

bottom line is that a hospital may send patients elsewhere if they cannot adequately treat them (ie. overcrowded, don't specialize in the needed area, etc.). They must, however, be sure not to send patients away simply based on that patient's ability to pay - so long as the hospital is eligible for federal funding of any sort (ie. medicaid, medicare). I don't see this as a situation where they are "dumping" patients. Therefore, it's both legal and smart. Failure to correctly treat patients could lead to huge malpractice suits. no one wants that.</htmltext>
<tokenext>legally they cant take patients in if they cant do an adequate job treating them .
i wouldnt be surprised if some of their regular staff was busy fixing the medical records .
therefore they were probably short on workers and also unable to keep adequate medical records for patients .
this is a big no-no in the health care industry .
bottom line is that a hospital may send patients elsewhere if they can not adequately treat them ( ie .
overcrowded , do n't specialize in the needed area , etc. ) .
They must , however , be sure not to send patients away simply based on that patient 's ability to pay - so long as the hospital is eligible for federal funding of any sort ( ie .
medicaid , medicare ) .
I do n't see this as a situation where they are " dumping " patients .
Therefore , it 's both legal and smart .
Failure to correctly treat patients could lead to huge malpractice suits .
no one wants that .</tokentext>
<sentencetext>legally they cant take patients in if they cant do an adequate job treating them.
i wouldnt be surprised if some of their regular staff was busy fixing the medical records.
therefore they were probably short on workers and also unable to keep adequate medical records for patients.
this is a big no-no in the health care industry.
bottom line is that a hospital may send patients elsewhere if they cannot adequately treat them (ie.
overcrowded, don't specialize in the needed area, etc.).
They must, however, be sure not to send patients away simply based on that patient's ability to pay - so long as the hospital is eligible for federal funding of any sort (ie.
medicaid, medicare).
I don't see this as a situation where they are "dumping" patients.
Therefore, it's both legal and smart.
Failure to correctly treat patients could lead to huge malpractice suits.
no one wants that.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209311</id>
	<title>they don't</title>
	<author>dunkelfalke</author>
	<datestamp>1244129100000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Problems with paper work don't make it necessary to turn away patients. But the paperwork is what brings the money to the hospital. Backlog of paperwork means backlog of income and meanwhile bills and wages have to be paid.</p></htmltext>
<tokenext>Problems with paper work do n't make it necessary to turn away patients .
But the paperwork is what brings the money to the hospital .
Backlog of paperwork means backlog of income and meanwhile bills and wages have to be paid .</tokentext>
<sentencetext>Problems with paper work don't make it necessary to turn away patients.
But the paperwork is what brings the money to the hospital.
Backlog of paperwork means backlog of income and meanwhile bills and wages have to be paid.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210285</id>
	<title>Lots can go wrong.</title>
	<author>gebbeth</author>
	<datestamp>1244133060000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Despite the reasons for the EHR outage and despite almost any amount of IT planning to mitigate this kind of outage, there are scenarios where such an outage are unavoidable.  Working for a hospital, I have seen where both of our WAN circuits have gone down due to fiber cuts  by construction contractors outside of our facility (a fairly common occurence in general).  There are certainly other ways of procurring connectivity like satellite and cellullar, but these are both prone to their own problems (satellite is affected by the weather and has very high latency and cellular is prone to interference, competes with other cellular users for bandwidth), and are relatively low bandwidth.  WAN connectivity isn't really the issue though,  Inside of a hospital you can have a dual core network infrastructure and have dual paths to all of your assets, you can have 5000 amp/hour batteries in all of the IDF's, you can over-engineer every aspect of the system and still have a failure somewhere that brings down your system.
<p>

Of course, you have to remember that all of this over-engineering costs money.  The more money a hospital spends on bulletproofing EHR, the more they have to charge patients or cut corners elsewhere in order to remain profitable.  At some point for any system, be it EHR or any other, this process becomes unsustainable as no one could afford the services of the hospital.</p><p>

Some may see this as a reason why for profit hospitals are bad and why the government should run things.  It really wouldn't change.  The government is currently effectively bankrupt.  We borrow billions from other countries and the Federal Reserve prints up the shortfall causing currency inflation.  When our debt becomes so large that our credit rating falters, other countries will be less and less inclined to finance our debts which will bring more inflation as the Fed continues to print the shortfall.  Why do people think that the government's budget is any different from a household budget?  How long can you keep spending more than you earn and stave off bankruptcy?
</p><p>

The fact of the matter is that a for profit organization has the most <i>incentive</i> to build the most effective and efficient system for dealing with their core business.  Of course, governmentrules and regulations and the organizations' leadership (if inept) can stymie this process.</p></htmltext>
<tokenext>Despite the reasons for the EHR outage and despite almost any amount of IT planning to mitigate this kind of outage , there are scenarios where such an outage are unavoidable .
Working for a hospital , I have seen where both of our WAN circuits have gone down due to fiber cuts by construction contractors outside of our facility ( a fairly common occurence in general ) .
There are certainly other ways of procurring connectivity like satellite and cellullar , but these are both prone to their own problems ( satellite is affected by the weather and has very high latency and cellular is prone to interference , competes with other cellular users for bandwidth ) , and are relatively low bandwidth .
WAN connectivity is n't really the issue though , Inside of a hospital you can have a dual core network infrastructure and have dual paths to all of your assets , you can have 5000 amp/hour batteries in all of the IDF 's , you can over-engineer every aspect of the system and still have a failure somewhere that brings down your system .
Of course , you have to remember that all of this over-engineering costs money .
The more money a hospital spends on bulletproofing EHR , the more they have to charge patients or cut corners elsewhere in order to remain profitable .
At some point for any system , be it EHR or any other , this process becomes unsustainable as no one could afford the services of the hospital .
Some may see this as a reason why for profit hospitals are bad and why the government should run things .
It really would n't change .
The government is currently effectively bankrupt .
We borrow billions from other countries and the Federal Reserve prints up the shortfall causing currency inflation .
When our debt becomes so large that our credit rating falters , other countries will be less and less inclined to finance our debts which will bring more inflation as the Fed continues to print the shortfall .
Why do people think that the government 's budget is any different from a household budget ?
How long can you keep spending more than you earn and stave off bankruptcy ?
The fact of the matter is that a for profit organization has the most incentive to build the most effective and efficient system for dealing with their core business .
Of course , governmentrules and regulations and the organizations ' leadership ( if inept ) can stymie this process .</tokentext>
<sentencetext>Despite the reasons for the EHR outage and despite almost any amount of IT planning to mitigate this kind of outage, there are scenarios where such an outage are unavoidable.
Working for a hospital, I have seen where both of our WAN circuits have gone down due to fiber cuts  by construction contractors outside of our facility (a fairly common occurence in general).
There are certainly other ways of procurring connectivity like satellite and cellullar, but these are both prone to their own problems (satellite is affected by the weather and has very high latency and cellular is prone to interference, competes with other cellular users for bandwidth), and are relatively low bandwidth.
WAN connectivity isn't really the issue though,  Inside of a hospital you can have a dual core network infrastructure and have dual paths to all of your assets, you can have 5000 amp/hour batteries in all of the IDF's, you can over-engineer every aspect of the system and still have a failure somewhere that brings down your system.
Of course, you have to remember that all of this over-engineering costs money.
The more money a hospital spends on bulletproofing EHR, the more they have to charge patients or cut corners elsewhere in order to remain profitable.
At some point for any system, be it EHR or any other, this process becomes unsustainable as no one could afford the services of the hospital.
Some may see this as a reason why for profit hospitals are bad and why the government should run things.
It really wouldn't change.
The government is currently effectively bankrupt.
We borrow billions from other countries and the Federal Reserve prints up the shortfall causing currency inflation.
When our debt becomes so large that our credit rating falters, other countries will be less and less inclined to finance our debts which will bring more inflation as the Fed continues to print the shortfall.
Why do people think that the government's budget is any different from a household budget?
How long can you keep spending more than you earn and stave off bankruptcy?
The fact of the matter is that a for profit organization has the most incentive to build the most effective and efficient system for dealing with their core business.
Of course, governmentrules and regulations and the organizations' leadership (if inept) can stymie this process.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209301</id>
	<title>David Carradine Has Died, He Was Delicious</title>
	<author>Anonymous</author>
	<datestamp>1244129100000</datestamp>
	<modclass>Offtopic</modclass>
	<modscore>-1</modscore>
	<htmltext><p>Words cannot describe how sad this is. Carradine's acting was top-notch for the hey-day of 60's Kung-fu pop culture. His purple colour (a colour option picked up from an earlier version) clashes with the grey of any other window, that can be changed though. The black of acting in Kill Bill (Vol. 1 &amp; 2) is overbearing and doesnt meld with his earlier works. His *cough* apparent suicide *cough* stands out like a sore thumb. I somehow feel like his death resembles the chrome looks like a webpage, rather than someone who won an award in 2005 for lifetime acting achievements and for browsing web pages. I cannot believe someone who created the Firefox icon could create something so hideous and inappropriate, especially when David Carradine's marketshare is bad enough already. I could not bear to look at this all day, every day, it would drive me mad.</p><p>A suicidal has-been Kung-fu actor should be transparent, a thin veneer between me and the web page. Not a clown honking his horn in my face. I went into preferences and changed to the Mac "native" theme and no particular colour, mildly improved, but still the black is overpowering, the new-tab button is the wrong colour, and the side pane has a tinge of blue that doesnt work well with the OS X grey. The tab touching the title bar also just looks poor and conflicting. <b>This is the same bullshit I had to put up with when Dana Plato finally offed herself.</b> It's goudy, non-native, clashes with the websites you view, and generally gets in the way, the toolkit underneath still rears it's ugly head in how the app works, and the general layout of the widgets. Apparently Carradine was eaten by wolves on the Connecticut turn-pike. All reports say he was delicious. The dialogues throughout the app crap all over the spacing guides in the HIG. Every inch of this app is annoying and grates on me. I'm not an interface elitist or an apple fanboy, but I can't use software that gets on my nerves and Opera and Vista occupy the top two slots for that. The browser is eclectic, with too many preferences, too complicated preferences, too many customisation options. Features not everybody needs, or wants.</p><p>=Smidge=</p></htmltext>
<tokenext>Words can not describe how sad this is .
Carradine 's acting was top-notch for the hey-day of 60 's Kung-fu pop culture .
His purple colour ( a colour option picked up from an earlier version ) clashes with the grey of any other window , that can be changed though .
The black of acting in Kill Bill ( Vol .
1 &amp; 2 ) is overbearing and doesnt meld with his earlier works .
His * cough * apparent suicide * cough * stands out like a sore thumb .
I somehow feel like his death resembles the chrome looks like a webpage , rather than someone who won an award in 2005 for lifetime acting achievements and for browsing web pages .
I can not believe someone who created the Firefox icon could create something so hideous and inappropriate , especially when David Carradine 's marketshare is bad enough already .
I could not bear to look at this all day , every day , it would drive me mad.A suicidal has-been Kung-fu actor should be transparent , a thin veneer between me and the web page .
Not a clown honking his horn in my face .
I went into preferences and changed to the Mac " native " theme and no particular colour , mildly improved , but still the black is overpowering , the new-tab button is the wrong colour , and the side pane has a tinge of blue that doesnt work well with the OS X grey .
The tab touching the title bar also just looks poor and conflicting .
This is the same bullshit I had to put up with when Dana Plato finally offed herself .
It 's goudy , non-native , clashes with the websites you view , and generally gets in the way , the toolkit underneath still rears it 's ugly head in how the app works , and the general layout of the widgets .
Apparently Carradine was eaten by wolves on the Connecticut turn-pike .
All reports say he was delicious .
The dialogues throughout the app crap all over the spacing guides in the HIG .
Every inch of this app is annoying and grates on me .
I 'm not an interface elitist or an apple fanboy , but I ca n't use software that gets on my nerves and Opera and Vista occupy the top two slots for that .
The browser is eclectic , with too many preferences , too complicated preferences , too many customisation options .
Features not everybody needs , or wants. = Smidge =</tokentext>
<sentencetext>Words cannot describe how sad this is.
Carradine's acting was top-notch for the hey-day of 60's Kung-fu pop culture.
His purple colour (a colour option picked up from an earlier version) clashes with the grey of any other window, that can be changed though.
The black of acting in Kill Bill (Vol.
1 &amp; 2) is overbearing and doesnt meld with his earlier works.
His *cough* apparent suicide *cough* stands out like a sore thumb.
I somehow feel like his death resembles the chrome looks like a webpage, rather than someone who won an award in 2005 for lifetime acting achievements and for browsing web pages.
I cannot believe someone who created the Firefox icon could create something so hideous and inappropriate, especially when David Carradine's marketshare is bad enough already.
I could not bear to look at this all day, every day, it would drive me mad.A suicidal has-been Kung-fu actor should be transparent, a thin veneer between me and the web page.
Not a clown honking his horn in my face.
I went into preferences and changed to the Mac "native" theme and no particular colour, mildly improved, but still the black is overpowering, the new-tab button is the wrong colour, and the side pane has a tinge of blue that doesnt work well with the OS X grey.
The tab touching the title bar also just looks poor and conflicting.
This is the same bullshit I had to put up with when Dana Plato finally offed herself.
It's goudy, non-native, clashes with the websites you view, and generally gets in the way, the toolkit underneath still rears it's ugly head in how the app works, and the general layout of the widgets.
Apparently Carradine was eaten by wolves on the Connecticut turn-pike.
All reports say he was delicious.
The dialogues throughout the app crap all over the spacing guides in the HIG.
Every inch of this app is annoying and grates on me.
I'm not an interface elitist or an apple fanboy, but I can't use software that gets on my nerves and Opera and Vista occupy the top two slots for that.
The browser is eclectic, with too many preferences, too complicated preferences, too many customisation options.
Features not everybody needs, or wants.=Smidge=</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28210343</id>
	<title>Re:Nurse != Secretary</title>
	<author>aukset</author>
	<datestamp>1244133480000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p><div class="quote"><p>Nurse != Secretary (Score:1)</p></div><p>I think this has more to do with Management not being able to properly bill insurance companies. Because profit is more important than human lives.</p></div><p>Aside from the fact that the inability to access medical records has <b>nothing</b> to do with the ability to bill a patient or their insurance carrier, your post shows you are very ignorant about how emergency medicine works.</p></div>
	</htmltext>
<tokenext>Nurse ! = Secretary ( Score : 1 ) I think this has more to do with Management not being able to properly bill insurance companies .
Because profit is more important than human lives.Aside from the fact that the inability to access medical records has nothing to do with the ability to bill a patient or their insurance carrier , your post shows you are very ignorant about how emergency medicine works .</tokentext>
<sentencetext>Nurse != Secretary (Score:1)I think this has more to do with Management not being able to properly bill insurance companies.
Because profit is more important than human lives.Aside from the fact that the inability to access medical records has nothing to do with the ability to bill a patient or their insurance carrier, your post shows you are very ignorant about how emergency medicine works.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_06_04_1358213.28209753</parent>
</comment>
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